It’s hard to believe that it’s already February, National Heart Month. Did you know?1
- Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups.
- One person dies every 34 seconds from cardiovascular disease.
- In 2023, 1 in every 3 deaths is due to cardiovascular disease.
- Coronary heart disease is the most common type of heart disease.
- About 5% of adults age 20 and older have coronary artery disease (CAD).
- In 2023, about 1 out of every 6 deaths from cardiovascular diseases (CVDs) was among adults younger than 65 years old.
- In the United States, someone has a heart attack every 40 seconds.
We need to take diagnosing and treating heart disease to heart!
I thought it might be helpful to share with you the diagnostic coding changes in Chapter 9, Diseases of the circulatory system (I00-I99), for 2026 (effective October 1, 2025)2:
- Expansion of subcategory I27.84 Fontan related circulation
- I27.840 Fontan-associated liver disease [FALD]
- I27.841 Fontan-associated lymphatic dysfunction
- Code also associated conditions such as:
- chylothorax (J94.0)
- Fontan associated protein-losing enteropathy (K90.89)
- plastic (obstructive) bronchitis (J44.89)
- I27.848 Other Fontan-associated condition
- Use Additional code to specify the Fontan associated condition
- I27.849 Fontan related circulation, unspecified
- Changes to Excludes notes under category I51 Complications and ill-defined descriptions of heart disease
- Delete the Excludes1 notes under the category I51 heading
- any condition in I51.4-I51.9 due to hypertension (I11.-)
- any condition in I51.4-I51.9 due to hypertension and chronic kidney disease (I13.-)
- heart disease specified as rheumatic (I00-I09)
- Add Excludes2 note under the category I51 heading
- heart disease specified as rheumatic (I00-I09)
- Add Excludes1 note under code I51.5 Myocardial degeneration
- myocardial degeneration due to hypertension (I11.-)
- myocardial degeneration due to hypertension and chronic kidney disease (I13.-)
- Add Excludes1 note under code I51.7 Cardiomegaly
- cardiomegaly due to hypertension (I11.-)
- cardiomegaly due to hypertension and chronic kidney disease (I13.-)
- Addition of Excludes2 note under code I70.9 Other and unspecified atherosclerosis
- disorders of pyrophosphate metabolism (E83.82-)
- Revision of a Code first note under category I80 Phlebitis and thrombophlebitis
- Code first, if applicable: phlebitis and thrombophlebitis complicating abortion, ectopic or molar pregnancy (O00-O07, O08.7)
You might be wondering, why the changes to the Excludes notes under category I51? It’s because there was a change to the ICD-10-CM Official Guidelines for Coding and Reporting3 for the chapter specific guideline for Hypertension with Heart Disease, Guideline I.C.9.a.1:
1) Hypertension with Heart Disease
Hypertension with heart conditions classified to I50.-, Heart failure, I51.4, Myocarditis, unspecified, I51.89, Other ill-defined heart diseases, and I51.9, Heart disease, unspecified, is assigned to a code from category I11, Hypertensive heart disease. Use additional code(s) from category I50, Heart failure, or I51, Complications and ill-defined descriptions of heart disease, to identify the heart condition.
Hypertension with heart conditions classified to I51.5, Myocardial degeneration, or I51.7, Cardiomegaly, is assigned to a code from category I11, Hypertensive heart disease. No additional code is assigned to identify the specific heart condition.
The same heart conditions (I50.-, I51.4-I51.7, I51.89, I51.9) with hypertension are coded separately if the provider has documented they are unrelated to the hypertension. The applicable hypertension code I10, Essential (primary) hypertension, or a code from category I15, Secondary hypertension, should be assigned. Sequence according to the circumstances of the admission/encounter.
As I always say, the only constant is change. In order to code correctly, it’s important that we stay up-to-date and understand the why behind the changes. I hope you’ve found this helpful. If so, please share the link with your colleagues.
