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ICD-10 Coding for Sudden Cardiac Arrest(I46.2, I46.8, I46.9)

Complete ICD-10-CM coding and documentation guide for Sudden Cardiac Arrest. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Cardiac ArrestSCA

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Related ICD-10 Code Ranges

Complete code families applicable to Sudden Cardiac Arrest

I46Primary Range

Cardiac arrest

This range includes all codes related to cardiac arrest, specifying different causes and conditions.

I21-I22

Acute myocardial infarction

These codes are used when cardiac arrest is due to an acute myocardial infarction.

R57

Shock, not elsewhere classified

Includes cardiogenic shock, which can occur alongside cardiac arrest.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
I46.2Cardiac arrest due to underlying cardiac conditionUse when cardiac arrest is due to a documented cardiac condition such as ventricular fibrillation.
  • Documented cardiac etiology
  • ECG showing arrhythmia
I46.8Cardiac arrest due to other conditionUse when cardiac arrest is due to non-cardiac causes.
  • Non-cardiac cause documented
  • Toxicological confirmation of overdose
I46.9Cardiac arrest, unspecifiedUse when the cause of cardiac arrest is not determined.
  • Etiology remains unknown after workup

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 sudden cardiac arrest

Essential facts and insights about Sudden Cardiac Arrest

Sudden cardiac arrest is coded under I46.x in ICD-10, with specific codes like I46.2 for cardiac causes.

Primary ICD-10-CM Codes for sudden cardiac arrest

I46.2
Cardiac arrest due to underlying cardiac condition
Billable Code

Decision Criteria

clinical Criteria

  • Presence of ventricular fibrillation

Applicable To

  • Cardiac arrest due to ventricular fibrillation

Excludes

  • Respiratory arrest (R09.2)

Clinical Validation Requirements

  • Documented cardiac etiology
  • ECG showing arrhythmia

Code-Specific Risks

  • Misclassification if underlying cause is not documented

Coding Notes

  • Ensure the underlying cardiac condition is documented and coded first.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Cardiogenic shock

R57.0
Use when cardiogenic shock is present alongside cardiac arrest.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Cardiac arrest due to other condition

I46.8
Use when the arrest is due to non-cardiac causes like drowning or overdose.

Cardiac arrest due to underlying cardiac condition

I46.2
Use when the arrest is due to a cardiac condition.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Sudden Cardiac Arrest to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I46.2.

Impact

Clinical: Leads to incomplete clinical picture., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.

Mitigation Strategy

Train staff on importance of detailed documentation., Use templates to ensure all elements are captured.

Impact

Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Ensure the underlying condition is coded first before cardiac arrest.

Impact

Reimbursement: May result in lower DRG payments., Compliance: Violation of coding standards., Data Quality: Misrepresentation of patient status.

Mitigation Strategy

Use I46.x codes for current treatment, not Z86.74.

Impact

Using I46.9 without documented workup.

Mitigation Strategy

Ensure thorough documentation and workup for all cardiac arrest cases.

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 Sudden Cardiac Arrest, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Sudden Cardiac Arrest

Use these documentation templates to ensure complete and accurate documentation for Sudden Cardiac Arrest. These templates include all required elements for proper coding and billing.

Out-of-Hospital Arrest with ROSC

Specialty: Emergency Medicine

Required Elements

  • Arrest Time
  • Witnessed Status
  • Initial Rhythm
  • CPR Quality
  • ROSC Time
  • Post-ROSC Status
  • Etiology

Example Documentation

55M found unresponsive at home by spouse. EMS witnessed coarse VF on monitor. ROSC achieved after 3 defibrillations and 4mg epi. Troponin-I 8.2 ng/mL. Cath lab activation showed 100% LAD occlusion.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient had cardiac arrest, now stable
Good Documentation Example
Witnessed PEA arrest at 14:22 with 23min CPR duration. ROSC achieved with 1mg epi. Post-arrest ECG shows ST elevation in leads V2-V4. Troponin-I 15.6 ng/mL. Presumed STEMI etiology.
Explanation
The good example provides detailed timing, interventions, and etiology, improving clinical clarity.

Need help with ICD-10 coding for Sudden Cardiac Arrest? Ask your questions below.

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