ICD-10 Coding for Interatrial Septal Defect(Q21.1, I23.1)
Complete ICD-10-CM coding and documentation guide for Interatrial Septal Defect. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Interatrial Septal Defect
Q21.1-Q21.15Primary Range
Congenital malformations of cardiac septa
This range includes various types of atrial septal defects, which are congenital heart defects.
Atrial septal defect as a current complication following acute myocardial infarction
Used for acquired atrial septal defects occurring post-myocardial infarction.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Q21.1 | Atrial septal defect | For congenital atrial septal defects with documented type and hemodynamic significance. |
|
| I23.1 | Atrial septal defect as a current complication following acute myocardial infarction | For acquired ASD following an acute myocardial infarction. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for atrial septal defect
Essential facts and insights about Interatrial Septal Defect
Primary ICD-10-CM Codes for interatrial septal defect
Decision Criteria
clinical Criteria
- Documented secundum or sinus venosus defect with right heart enlargement.
Applicable To
- Secundum ASD
- Sinus venosus defect
Excludes
- Atrioventricular septal defect (Q21.2)
Clinical Validation Requirements
- Echocardiogram showing defect size ≥5 mm
- Right heart enlargement
- Shunt quantification (Qp:Qs ≥1.5)
Code-Specific Risks
- Confusion with patent foramen ovale (Q21.12)
- Missing documentation of defect type
Coding Notes
- Ensure documentation specifies the type of ASD and any associated syndromes.
I23.1 - Atrial septal defect as a current complication following acute myocardial infarction
For acquired ASD following an acute myocardial infarction.
Clinical Validation Requirements
- Post-MI echocardiogram showing septal rupture
- Documentation of recent myocardial infarction
Coding Notes
Ensure proper sequencing with myocardial infarction codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Down syndrome
Q90.9Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Atrioventricular septal defect
Q21.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Interatrial Septal Defect to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Q21.1.
Impact
Clinical: Impairs treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use specific terminology, Include echocardiogram findings
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misrepresentation of patient condition., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Use Q21.12 for PFO without hemodynamic significance.
Impact
Use of unspecified codes without defect type.
Mitigation Strategy
Ensure documentation specifies defect type and size.
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 Interatrial Septal Defect, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Interatrial Septal Defect
Use these documentation templates to ensure complete and accurate documentation for Interatrial Septal Defect. These templates include all required elements for proper coding and billing.
Secundum ASD with planned closure
Specialty: CardiologyRequired Elements
- Defect type and size
- Shunt quantification
- Right heart strain
- Closure plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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