ICD-10 Coding for Alcoholic Cardiomyopathy(I42.6)
Complete ICD-10-CM coding and documentation guide for Alcoholic Cardiomyopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Alcoholic Cardiomyopathy
I42-I43Primary Range
Cardiomyopathy
This range includes all types of cardiomyopathy, with I42.6 specifically for alcoholic cardiomyopathy.
Mental and behavioral disorders due to use of alcohol
This range is used to code the presence of alcohol use, abuse, or dependence, which is necessary for coding alcoholic cardiomyopathy.
Key Information: ICD-10 code for alcoholic cardiomyopathy
Essential facts and insights about Alcoholic Cardiomyopathy
Primary ICD-10-CM Code for alcoholic cardiomyopathy
Decision Criteria
clinical Criteria
- Patient has a history of heavy alcohol use and echocardiogram shows dilated cardiomyopathy.
documentation Criteria
- Documentation specifies 'alcoholic cardiomyopathy' and details alcohol consumption.
Applicable To
- Cardiomyopathy due to chronic alcohol use
Clinical Validation Requirements
- History of heavy alcohol use (>80g/day for 5+ years)
- Echocardiogram showing dilated cardiomyopathy
- Elevated liver enzymes or macrocytosis
Code-Specific Risks
- Confusing with drug-induced cardiomyopathy
- Incorrect sequencing with alcohol use codes
Coding Notes
- Ensure documentation explicitly links cardiomyopathy to alcohol use.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Alcoholic Cardiomyopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I42.6.
Impact
Clinical: May lead to misdiagnosis or incorrect treatment plans., Regulatory: Could result in audit discrepancies., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Train staff on detailed documentation practices., Use templates to ensure comprehensive history taking.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment and reimbursement., Compliance: May result in compliance issues during audits., Data Quality: Affects the accuracy of patient records and data analytics.
Mitigation Strategy
Verify the primary substance causing cardiomyopathy through patient history and documentation.
Impact
Incorrect sequencing of I42.6 and F10 codes.
Mitigation Strategy
Educate coders on proper sequencing rules and provide examples.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Alcoholic Cardiomyopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Alcoholic Cardiomyopathy
Use these documentation templates to ensure complete and accurate documentation for Alcoholic Cardiomyopathy. These templates include all required elements for proper coding and billing.
Chronic alcoholic cardiomyopathy diagnosis
Specialty: CardiologyRequired Elements
- Patient's alcohol consumption history
- Echocardiogram results
- Liver function tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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