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Cardiologists and Cardiology Coding in ICD-10-CM and CPT: Learn the Truth

Cardiology Coding in ICD-10-CM and CPT
An amusing image of a cardiologist dealing out playing cards.
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** This article was reviewed and updated on January 25, 2024. **

Cardiology Coding in ICD-10-CM and CPT

In healthcare and medical coding, the term “cardiologist” might conjure up some amusing images of doctors dealing out playing cards. Still, the reality is far from this comical misconception. In this article, we dive into the field of cardiology to explain the genuine duties of cardiologists, explore the distinctions between heart disease and cardiovascular disease, break down the complexity of the cardiovascular system, translate heart-related medical terms, and shed light on frequently used ICD-10-CM and CPT codes reported in this branch of medicine.

What is a Cardiologist?

A cardiologist is not a dealer of cards but a specialist in cardiovascular disease who diagnoses and treats heart-related conditions. Knowing your medical terminology can help here, as the term “cardiologist” can be broken down to find its meaning: “cardi” means heart, and “-ologist” means specialist. Hence, a cardiologist is a heart specialist, not a card distributor.

Cardiologists do not play cards as part of their profession. Instead, they diagnose and treat heart-related conditions.

Responsibilities of a Cardiologist

According to The Society of Thoracic Surgeons, cardiologists are dedicated professionals who treat severe hypertension, elevated cholesterol, and heart rhythm disorders (arrhythmias), among other conditions. They perform essential tasks such as stress tests and echocardiograms to identify heart issues, while specialized cardiologists step in to perform specific procedures like stent placements and device implantations. Still, other cardiologists perform ablation procedures for atrial fibrillation or other rhythm problems and implant pacemakers or defibrillators for more serious rhythm disturbances.

Cardiologists work in private practices, hospitals, and universities.

Distinguishing Heart Disease from Cardiovascular Disease

While the terms “heart disease” and “cardiovascular disease” are often used interchangeably, it’s important to note that the National Heart, Lung, and Blood Institute highlights distinct differences between cardiovascular disease and heart disease.

Cardiovascular disease is an umbrella term encompassing a range of conditions affecting the heart and blood vessels, including coronary heart disease, marked by artery blockages that can trigger heart attacks, strokes, heart failure, and peripheral artery disease.

On the other hand, heart disease is a comprehensive term consisting of various heart-related structural and functional disorders. Among these, the most prevalent form is coronary heart disease, also known as coronary artery disease. When many people talk about “heart disease,” they often mean coronary heart disease. 

Coronary heart disease occurs when plaque, consisting of substances like fat, cholesterol, and calcium, accumulates within the arteries. This process, called atherosclerosis or clogged arteries, reduces the flow of oxygen-rich blood to the heart, resulting in angina (chest pain) or the formation of blood clots. These clots are the primary cause of heart attacks.

Functions of the Cardiovascular System

According to The National Center for Biotechnology Information, the cardiovascular system, also known as the circulatory system, comprises the heart, blood vessels consisting of arteries, veins, capillaries, and the blood itself. Its primary role is transporting vital oxygen and nutrients throughout the body, sustaining every cell and organ.

The term ‘cardiovascular’ can be broken down in this way: cardio means heart; -vas- means vessel; -ular means relating to. In other words, ‘cardiovascular’ relates to the heart and blood vessels.

The individual functions of the heart, blood vessels, and blood are as follows:

  • Heart: a pumping device that receives blood from the veins and pumps it back into the arteries
  • Blood vessels: tubes that carry the blood through the body and consist of:
    • Arteries: carry blood away from the heart to all areas of the body, with the aorta being the largest artery in the body
    • Veins: carry the blood from the body back to the heart
    • Capillaries: microscopic blood vessels that connect the arteries and veins and allow nutrients and waste products to transfer between the blood and the cells
  • Blood: delivers oxygen and nutrients to all cells in the body and transfers waste out of the body 

Many terms are linked to the heart and its functions and even contain combining forms of card, cardi, or cardi/o. According to The Free Dictionary, some heart-related terms and their meanings include: 

  • Bradycardia: slowness of the heart rate, usually fewer than 60 beats per minute in an adult human
  • Cardiac: of, near, or relating to the heart
  • Cardiology: study and treatment of the heart and its functions
  • Carditis: inflammation of the muscle tissue of the heart
  • Cardiograph: an instrument used to record the mechanical movements of the heart
  • Cardiomegaly: abnormal enlargement of the heart
  • Cardiopulmonary: of, relating to, or involving both the heart and the lungs
  • Cardiovascular: of, relating to, or concerning the heart and the blood vessels
  • Echocardiogram: a visual record produced by echocardiography
  • Epicardial: inner layer of the pericardium that is in actual contact with the surface of the heart
  • Myocarditis: inflammation of the myocardium (heart muscle)
  • Tachycardia: a rapid heart rate, especially one above 100 beats per minute in an adult

Other heart-related medical terms and their combining forms include:

  • Blood vessels: angi/o, vas/o
  • Blood: hem/o, hemat/o
  • Arteries: arteri/o
  • Capillaries: capill/o
  • Veins: phleb/o, ven/o

Also, something to remember: Coronary artery disease (CAD) and coronary heart disease (CHD) are used interchangeably and mean the same thing. CAD/CHD is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis is the buildup of cholesterol and plaques on the inner walls of the arteries.

Common Medical Codes Used in Cardiology

A medical coder working in a cardiology practice uses ICD-10-CM codes to classify diseases and CPT to depict procedures. Below are some ICD-10-CM and CPT codes a coder may assign.

Consistently high blood pressure readings can result in a diagnosis of hypertension.

ICD-10-CM Codes

  • I10 Essential (primary) hypertension
  • I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery
  • I21.3 ST elevation (STEMI) myocardial infarction of unspecified site
  • I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
  • I42.9 Cardiomyopathy, unspecified
  • I48.0 Paroxysmal atrial fibrillation
  • I49.01 Ventricular fibrillation
  • I50.31 Acute diastolic (congestive) heart failure
  • I50.9 Heart failure, unspecified
  • I63.9 Cerebral infarction, unspecified
A cardiovascular stress test is performed using a treadmill. This procedure may be performed to diagnose coronary artery disease or an irregular heart rhythm.

CPT Codes

  • 33208 Insertion of new or replacement permanent pacemaker with transvenous electrode(s); atrial and ventricular
  • 93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography
  • 93015 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report
  • 92928 Percutaneous transcatheter placement of an intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
  • 93224 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
  • 93350 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise, and/or pharmacologically induced stress, with interpretation and report
  • 93454 Transthoracic Doppler echocardiography; complete study
  • 93458 Coronary angiography, right heart, with left heart catheterization, including coronary angiography; single vessel
  • 93510 Right heart catheterization, including measurement(s) of oxygen saturation and intracardiac pressure(s)
  • 93543 Intravascular ultrasound (IVUS) study of coronary arteries, including plaque characterization analysis

Conclusion

Let’s dispel the notion that cardiologists are in the business of cards. Their true profession involves safeguarding and nurturing hearts, not dealing cards. By understanding cardiology, you gain insight into cardiologists’ critical role in diagnosing and treating heart-related issues. As a medical coder, mastering cardiovascular terminology and ICD-10-CM and CPT codes ensures accurate documentation of diagnoses and procedures, contributing to effective patient care.

Cardiology Coding in ICD-10-Cm and CPT
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