ICD-10 Coding for Ischemic Dilated Cardiomyopathy(I25.5, I42.0)
Complete ICD-10-CM coding and documentation guide for Ischemic Dilated Cardiomyopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ischemic Dilated Cardiomyopathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I25.5 | Ischemic cardiomyopathy | Use when cardiomyopathy is due to ischemic heart disease. |
|
| I42.0 | Dilated cardiomyopathy | Use when cardiomyopathy is not due to ischemic heart disease. |
|
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 ischemic dilated cardiomyopathy
Essential facts and insights about Ischemic Dilated Cardiomyopathy
Primary ICD-10-CM Codes for ischemic dilated cardiomyopathy
Decision Criteria
clinical Criteria
- Presence of coronary artery disease with left ventricular dilation
documentation Criteria
- Explicit mention of ischemic cause in medical records
Applicable To
- Ischemic dilated cardiomyopathy
Excludes
- Non-ischemic dilated cardiomyopathy (I42.0)
Clinical Validation Requirements
- Echocardiogram showing left ventricular dilation
- Evidence of coronary artery disease via angiography
Code-Specific Risks
- Incorrectly coding as non-ischemic cardiomyopathy
Coding Notes
- Ensure documentation clearly links cardiomyopathy to ischemic etiology.
I42.0 - Dilated cardiomyopathy
Use when cardiomyopathy is not due to ischemic heart disease.
Applicable To
- Non-ischemic dilated cardiomyopathy
Excludes
- Ischemic cardiomyopathy (I25.5)
Clinical Validation Requirements
- Echocardiogram showing left ventricular dilation without ischemic cause
Coding Notes
Ensure ischemic causes are ruled out before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Heart failure, unspecified
I50.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ischemic Dilated 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: Mismanagement of treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Regular training on documentation standards, Use of EHR prompts for ischemic documentation
Impact
Reimbursement: Incorrect DRG assignment leading to potential revenue loss., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Use I25.5 for ischemic causes.
Impact
Using I42.0 for ischemic cases.
Mitigation Strategy
Regular audits and coder education.
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 Dilated Cardiomyopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ischemic Dilated Cardiomyopathy
Use these documentation templates to ensure complete and accurate documentation for Ischemic Dilated Cardiomyopathy. These templates include all required elements for proper coding and billing.
Ischemic Dilated Cardiomyopathy Diagnosis
Specialty: CardiologyRequired Elements
- Etiological statement linking ischemia to cardiomyopathy
- Imaging results confirming diagnosis
- Temporal context of ischemic events
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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