ICD-10 Coding for Ischemic Cardiomyopathy(I25.5)
Complete ICD-10-CM coding and documentation guide for Ischemic Cardiomyopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ischemic Cardiomyopathy
I25.5Primary Range
Ischemic Cardiomyopathy
Primary code for ischemic cardiomyopathy, indicating heart muscle weakness due to coronary artery disease.
Acute Myocardial Infarction
Used when ischemic cardiomyopathy is accompanied by a recent myocardial infarction.
Key Information: ICD-10 code for ischemic cardiomyopathy
Essential facts and insights about Ischemic Cardiomyopathy
Primary ICD-10-CM Code for ischemic cardiomyopathy
Decision Criteria
clinical Criteria
- Presence of CAD with reduced LVEF
coding Criteria
- Use I25.5 when CAD is the primary cause of cardiomyopathy
documentation Criteria
- Document CAD and LVEF findings
Applicable To
- Heart failure due to coronary artery disease
Excludes
- Non-ischemic cardiomyopathy (I42.0)
Clinical Validation Requirements
- LVEF <40% with documented CAD
- Coronary angiography showing significant stenosis
Code-Specific Risks
- Misclassification with non-ischemic cardiomyopathy
Coding Notes
- Ensure documentation specifies ischemic etiology to avoid misclassification.
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 Ischemic Cardiomyopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I25.5.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Review CAD history during documentation, Ensure all relevant tests are recorded
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use I25.5 when CAD is the cause of cardiomyopathy.
Impact
Using I42.0 instead of I25.5 for ischemic causes.
Mitigation Strategy
Educate staff on correct code application.
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 Ischemic Cardiomyopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ischemic Cardiomyopathy
Use these documentation templates to ensure complete and accurate documentation for Ischemic Cardiomyopathy. These templates include all required elements for proper coding and billing.
Cardiology Progress Note
Specialty: CardiologyRequired Elements
- CAD history
- LVEF measurement
- Heart failure symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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