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Smiling Businesswoman Wearing Red

Feb. 4 has been designated as National Wear Red Day to focus awareness on cardiovascular disease among women.

The beginning of February is busy this year with Chinese New Year (Feb. 1), Groundhog Day (Feb. 2), and National Wear Red Day (Feb. 4).

Heart disease is the leading cause of death for women in the United States. One out of five women die from heart disease.   The Centers for Disease Control and Prevention (CDC) states that 299,578 women died from heart disease in 2017.   Heart disease claims the same number of lives of white and African American women and is the leading cause of death. For American Indian and Alaskan Native women, heart disease claims the same number of lives as cancer.   Heart disease is the second leading cause of death for Hispanic, Asian, and Pacific Islander women.

The risk factors for heart disease include high blood pressure, high low-density lipoprotein (LDL) cholesterol, and smoking.   Comorbid conditions and lifestyle choices can also put women at risk include diabetes; overweight or obesity; eating an unhealthy diet; physical inactivity; and drinking too much alcohol.  The risks can be reduced by knowing your blood pressure; testing for diabetes or controlling it; stopping smoking if you smoke; checking your blood cholesterol and triglycerides; eating healthy; limiting alcohol to one drink per day; and managing stress levels.

The ICD-10-CM codes for heart disease can be found in Chapter 9 or the “I” codes.   Coronary artery disease is found in the range of “Ischemic Heart Diseases (I20 – I25)”.  This range includes diagnosis codes for angina (I20), acute myocardial infarction (I21), and chronic ischemic heart disease (I25).  Coronary artery disease is based on disease in the native, bypass grafts, or transplanted heart AND if the patient has angina pectoris.   The specificity of the type of grafts can also affect code assignment.   The specificity includes autologous (comes from the patient) or non-autologous (comes from someone other than the patient).   The coder is also instructed to add codes for smoking status, coronary atherosclerosis due to calcified lesion (I25.84), coronary atherosclerosis due to lipid rich plaque (I25.83) and chronic total occlusion of coronary artery (I25.82).  One of the new FY22 diagnosis codes, I5A (non-ischemic myocardial injury) is identified as an Excludes 2 note for this range.

The Medicare-Severity Diagnosis Related Group (MS-DRG) will be dependent upon if surgery was performed, and the type of surgery performed.  The grouper also will account for a secondary diagnosis of major complication/condition (MCC) or complication/comorbid condition (CC), if present.   The surgery could be endovascular (through a catheter) or sternotomy (open) and if a cardiac catheterization as performed.  All the MS-DRGs can be found in Major Diagnostic Category 5 (Diseases and Disorders of the Circulatory System).

Enjoy the beginning of this new month, but don’t forget to wear red on Friday, Feb. 4 to support the women in your life.

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Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

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