Coronary Artery Disease – Symptoms, Diagnosis and Medical Coding
Coronary artery disease (CAD) is the narrowing or blockage of the coronary arteries – the blood vessels that supply blood, oxygen and nutrients to the heart. Also called coronary heart disease (CHD) or ischemic heart disease, the condition develops when the major blood vessels become damaged or diseased. Typically, it occurs when hard cholesterol (plaque) gets deposited within the artery. A buildup of plaque can result in the formation of tiny clots that may obstruct or reduce the flow of blood to the heart muscles. In due course, the reduced blood flow may cause chest pain (angina), shortness of breath, or even complete blockage. Proper documentation is necessary to justify medical necessity and selection of codes for billing. A reliable cardiology medical billing company can help in ensuring accurate and timely claim submission for appropriate reimbursement.
Regarded as the most common form of heart disease, CAD affects approximately 16.5 million Americans over the age of 20 (2020 statistics). It is estimated that every 40 seconds, someone in the United States suffers a heart attack.
Symptoms of CAD
Initially, the reduced blood flow associated with the condition may not cause any specific symptoms. However, when the heart doesn’t get enough arterial blood, patients may experience a variety of symptoms. Angina or chest discomfort is one of the most common symptoms of CAD. Angina can happen when too much plaque builds up inside the arteries, causing them to narrow. Narrowed arteries can cause chest pain as they block blood flow to the heart muscle and the rest of the body. Other related symptoms include - pain in the arms or shoulders, shortness of breath, sweating, irregular heartbeat, dizziness and nausea. In most cases, women are more likely to experience symptoms than men. If undiagnosed in its early stages and remains untreated, CAD may cause several complications like – chest pain (angina), heart attack, heart failure and abnormal heart rhythm (arrhythmia). Overweight, physical inactivity, unhealthy eating habits and smoking tobacco can increase the risk associated with the condition. A family history of heart disease also increases one’s risk for CAD, especially a family history of heart disease at an early age (50 or younger).
Diagnosing and Treating CAD
The initial diagnosis of CAD involves a detailed medical history review and physical examination. Physicians may also request routine blood tests to study the symptoms of the condition. Routine diagnostic imaging tests like - electrocardiogram (ECG), echocardiogram, exercise stress test, cardiac CT scan, cardiac catheterization and angiogram to identify detailed images of heart arteries may be performed. Treatment for CAD depends on the current health condition, risk factors, and overall wellbeing of the person. Treatment options involves serious lifestyle changes, medications, and if necessary certain medical procedures.
Incorporating healthy lifestyle changes like – quitting smoking, eating healthy foods, stopping alcohol consumption, exercising regularly, reducing excess body weight and eating a healthy diet can reduce the risk of heart disease and stroke. Medications include - cholesterol-modifying medications, beta blockers, calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).However, if the heart condition doesn’t improve with lifestyle changes and medications, physicians may recommend certain procedures to increase blood flow to the heart. Common procedures include -balloon angioplasty (to widen blocked arteries and smoosh down the plaque buildup), coronary artery bypass graft surgery (to restore blood flow to the heart) and enhanced external counter pulsation (to stimulate the formation of new small blood vessels).
Treatment procedures administered by cardiologists or other specialists must be documented using the right medical codes. Medical billing services provided by reputable billing and coding companies ensure this so that accurate claim submissions are done.
ICD-10 diagnosis codes for CAD include –
I25 – Chronic ischemic heart disease
I25.1 – Atherosclerotic heart disease of native coronary artery
I25.10 – Atherosclerotic heart disease of native coronary artery, without angina pectoris
I25.11 – Atherosclerotic heart disease of native coronary artery with angina pectoris
I25.110 – Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111 – Atherosclerotic heart disease of native coronary artery with unstable angina pectoris, with documented spasm
I25.118 – Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119 – Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
The outlook for coronary artery disease (CAD) is different and may vary from person to person and the type of symptoms they experience. Implementing serious lifestyle changes, administering treatment modalities and following the physician’s instructions correctly can help prevent extensive damage to the heart. Healthcare providers need to be knowledgeable about the highly specific ICD-10 codes to report coronary artery disease. A reliable medical billing and coding company can provide the support physicians need to ensure accurate claim submission for optimal reimbursement.
