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ICD-9-CM
Expert
for Payers
Volumes 1, 2 & 3
International Classification of Diseases
9th Revision
Clinical Modification
Sixth Edition
Edited by:
Anita C. Hart, RHIA, CCS, CCS-P
Catherine A. Hopkins
Beth Ford, RHIT, CCS
Ingenix is committed to providing you with the ICD-9-CM code update information you need to
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additional ICD-9-CM code changes effective April 1, 2006, Ingenix will provide these code changes
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Codes Valid October 1, 2005, through September 30, 2006
Tabular List
CIRCULATORY SYSTEM
Nerve Conduction of the Heart
425.8–427.0
426.3
426.4
k 426.5
425.8
425.9
¥<C
> ardiomyopathy in other diseases classified CC
¥e
> lsewhere
CD
Code first underlying disease, as:
Friedreich’s ataxia (334.0)
myotonia atrophica (359.2)
progressive muscular dystrophy (359.1)
sarcoidosis (135)
EXCLUDES
cardiomyopathy in Chagas’ disease
(086.0)
CC Excl: See code 425.0
AHA: 2Q, ‘93, 9
CC CD
Secondary cardiomyopathy, unspecified
CC Excl: See code 425.0
426.54 Trifascicular block
CC Excl: See code 426.0
426.6
426.7
' 426 Conduction disorders
DEF: Disruption or disturbance in the electrical impulses that regulate
heartbeats.
426.0
k 426.1
426.2
'
k
CC MC
Atrioventricular block, complete
Third degree atrioventricular block
CC Excl: 426.0-426.9, 427.0-427.5, 427.89, 459.89, 459.9
Atrioventricular block, other and unspecified
MC
426.10 Atrioventricular block, unspecified
Atrioventricular [AV] block (incomplete)
(partial)
426.11 First degree atrioventricular block
Incomplete atrioventricular block, first
degree
Prolonged P-R interval NOS
CC MC
426.12 Mobitz (type) II atrioventricular
block
Incomplete atrioventricular block:
Mobitz (type) II
second degree, Mobitz (type) II
CC Excl: See code 426.0
DEF: Impaired conduction of excitatory impulse from
cardiac atrium to ventricle through AV node.
426.13 Other second degree atrioventricular CC MC
block
Incomplete atrioventricular block:
Mobitz (type) I [Wenckebach’s]
second degree:
NOS
Mobitz (type) I
with 2:1 atrioventricular response [block]
Wenckebach’s phenomenon
CC Excl: See code 426.0
DEF: Wenckebach’s phenomenon: impulses generated at
constant rate to sinus node, P-R interval lengthens;
results in cycle of ventricular inadequacy and shortened
P-R interval; second-degree A-V block commonly called
"Mobitz type 1.”
¥<L
> eft bundle branch hemiblock
Block:
left anterior fascicular
left posterior fascicular
Additional Digit Required
2006 ICD•9•CM (02/06)
Nonspecific PDx
Unacceptable PDx
Manifestation Code
MC
O
¥> ther left bundle branch block
Left bundle branch block:
NOS
anterior fascicular with posterior fascicular
complete
main stem
R
¥> ight bundle branch block
AHA: 3Q, ‘00, 3
Bundle branch block, other and unspecified
426.50 ¥B
<> undle branch block, unspecified
MC
426.51 Right bundle branch block and left
posterior fascicular block
MC
426.52 Right bundle branch block and left
anterior fascicular block
426.53 Other bilateral bundle branch block CC MC
Bifascicular block NOS
Bilateral bundle branch block NOS
Right bundle branch with left bundle
branch block (incomplete) (main stem)
CC Excl: See code 426.0
k 426.8
CC MC
CC
Other heart block
Intraventricular block: Sinoatrial block
NOS
Sinoauricular block
diffuse
myofibrillar
CC Excl: See code 426.0
CC
Anomalous atrioventricular excitation
Atrioventricular conduction:
accelerated
accessory
pre-excitation
Ventricular pre-excitation
Wolff-Parkinson-White syndrome
CC Excl: See code 426.0
DEF: Wolff-Parkinson-White: normal conduction pathway is
bypassed; results in short P-R interval on EKG; tendency to
supraventricular tachycardia.
Other specified conduction disorders
CC
426.81 Lown-Ganong-Levine syndrome
Syndrome of short P-R interval, normal QRS
complexes, and supraventricular
tachycardias
CC Excl: See code 426.0
426.82 Long QT syndrome
AHA: w4Q, ’05, 72x
DEF: Condition characterized by recurrent syncope, malignant
arrhythmias, and sudden death; characteristic prolonged Q-T
interval on electrocardiogram.
426.9
426.89 Other
Dissociation:
atrioventricular [AV]
interference
isorhythmic
Nonparoxysmal AV nodal tachycardia
CC Excl: See code 426.0
CC
Conduction disorder, unspecified
Heart block NOS
Stokes-Adams syndrome
CC Excl: See code 426.0
CC
' 427 Cardiac dysrhythmias
EXCLUDES
that complicating:
abortion (634-638 with .7, 639.8)
ectopic or molar pregnancy (639.8)
labor or delivery (668.1, 669.4)
AHA: J-A, ‘85, 15
DEF: Disruption or disturbance in the rhythm of heartbeats.
MSP
Medicare Secondary Payer
wx Revised Text
l New Code
s Revised Code Title
February 2006 • Volume 1 — 123
Tabular List
37.67 ¥I> mplantation of cardiomyostimulation
¥s> ystem
Note: Two-step open procedure consisting of
tranfer of one end of the latissimus
dorsi muscle; wrapping it around the
heart; rib resection; implantation of
epicardial cardiac pacing leads into
the right ventricle; tunneling and
pocket creation for the
cardiomyostimulator.
AHA: 4Q, ‘98, 75; 1Q, ‘98, 8
Insertion of Pacemaker
37.68 ¥<I> nsertion of percutaneous external heart
¥a
> ssist device
Circulatory assist device
Extrinsic heart assist device
pVAD
Percutaneous heart assist device
INCLUDES
percutaneous [femoral]
insertion of cannulae
attachments
Insertion, revision, replacement, and removal of
pacemaker leads; insertion of temporary pacemaker
system; or revision of cardiac device pocket
Code also any insertion and replacement of
pacemaker device (37.80-37.87)
EXCLUDES
implantation or replacement of
transvenous lead [electrode] into
left ventricular cardiac venous
system (00.52)
AHA: 1Q, ‘94, 16; 3Q, ‘92, 3; M-J, ‘87, 1
' 37.7
s
37.67–37.79
OPERATIONS ON THE CARDIOVASCULAR SYSTEM
10
10
11
37.70 <¥I> nitial insertion of lea<¥d
> [electrode], not
<¥o
> therwise specified <¥>
EXCLUDES
insertion of temporary
transvenous pacemaker
system (37.78)
replacement of atrial and/or
ventricular lead(s) (37.76)
37.71 <I¥> nitial insertion of transvenous lead
<[¥> electrode] into ventricle
EXCLUDES
insertion of temporary
transvenous pacemaker
system (37.78)
replacement of atrial and/or
ventricular lead(s) (37.76)
37.72 <I¥> nitial insertion of transvenous leads
<[¥> electrodes] into atrium and ventricle
EXCLUDES
insertion of temporary
transvenous pacemaker
system (37.78)
replacement of atrial and/or
ventricular lead(s) (37.76)
AHA: 2Q, ‘97, 4
12
37.76
37.77
37.78
s
37.79
¥> eplacement of transvenous atrial and/or
R
v¥> entricular lead(s) [electrode]
Removal or abandonment of existing
transvenous or epicardial lead(s) with
transvenous lead(s) replacement
EXCLUDES
replacement of epicardial lead
[electrode] (37.74)
¥> emoval of lead(s) [electrode] without
R
r¥> eplacement
Removal:
epicardial lead (transthoracic approach)
transvenous lead(s)
EXCLUDES
removal of temporary transvenous pacemaker
system — omit code
that with replacement of:
atrial and/or ventricular
lead(s) [electrode]
(37.76)
epicardial lead [electrode]
(37.74)
Insertion of temporary transvenous
pacemaker system
EXCLUDES
intraoperative cardiac
pacemaker (39.64)
AHA: 3Q, ‘93, 12; 1Q, ‘89, 2
¥> evision or relocation of cardiac device
R
p
¥> ocket
Debridement and reforming pocket (skin
and subcutaneous tissue)
Relocation of pocket [creation of new pocket]
pacemaker or CRT-P
wRevision or relocation of pacemaker,
defibrillator, or other implanted
cardiac device pocketx
37.73 <I¥> nitial insertion of transvenous lead
Left Atrial Appendage Device Insertion
<[¥> electrode] into atrium
EXCLUDES
insertion of temporary
transvenous pacemaker
system (37.78)
replacement of atrial and/or
ventricular lead(s) (37.76)
13 37.74
<¥I> nsertion or replacement of epicardial lead
¥[> electrode] into epicardium
Insertion or replacement of epicardial lead by:
sternotomy
thoracotomy
EXCLUDES
replacement of atrial and/or
ventricular lead(s) (37.76)
37.75 R
¥> evision of lead [electrode]
Repair of electrode [removal with re-insertion]
Repositioning of lead [electrode]
Revision of lead NOS
EXCLUDES
repositioning of temporary
transvenous pacemaker
system — omit code
AHA: 2Q, ‘99, 11
Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.81, 37.82, 37.85, 37.86, 37.87
Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.83
Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.85, 37.86, 37.87
Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.81, 37.82, 37.83, 37.85, 37.86, 37.87
10
10
11
12
13
3
' Additional Digit Required
2006 ICD•9•CM
Nonspecific OR Procedure
Valid OR Procedure
Non-OR Procedure
Adjunct Code
October 2005 • Volume 3 — 125
Resources
2006 ICD•9•CM
Resources — 15
Home Health PPS Clinical Dimension
Diagnosis List
Home Health PPS Clinical Dimensions Group
The home health resource group (HHRG) classification system includes the clinical dimensions case mix group. The data elements are organized into three
dimensions; clinical, functional, and service utilization. The clinical dimension is defined by certain primary and secondary diagnosis codes as reported on the
OASIS assessment instrument under data elements M0230 and M0240. Codes with four and five digits must be coded to that level on the OASIS assessment
instrument. A list of those primary and secondary codes is provided in this resource. Refer to the “Overview of the Home Health Agency Prospective Payment
System” resource in your code book for a more detailed discussion of the case mix classification system.
Reminder: All codes designated with an asterisk (*) represent sequence or range of codes and any codes within that code category or subcategory are
represented. All codes should be reported to the highest level of specificity. Codes indicated at the three and four digit levels include all related four and five
digit codes. Diagnosis codes with four and five digits must be coded to that level on the OASIS assessment instrument.
Orthopedic
Primary Diagnoses
*170
*171
*213
274.0
*274.1
*274.8
274.9
*710
*711.0
*711.9
*712.8
*712.9
714.0
714.1
714.2
*714.3
714.4
*714.8
714.9
*716.0
*716.1
*716.2
*716.3
*716.4
*716.5
716.61
716.62
716.63
716.64
716.65
716.66
716.67
716.68
*716.8
*716.9
717.0
717.1
717.2
717.3
*717.4
717.5
717.6
717.7
*717.8
717.9
718.00
718.01
718.02
718.03
718.04
718.05
718.07
718.08
114 — Resources
718.09
718.10
718.11
718.12
718.13
718.14
718.15
718.17
718.18
718.19
*718.2
*718.3
*718.4
*718.5
718.60
718.65
*718.7
*718.8
718.90
718.91
718.92
718.93
718.94
718.95
718.97
718.98
718.99
720.0
720.1
720.2
720.89
720.9
721.0
721.1
721.2
721.3
721.41
721.42
721.5
721.6
721.7
721.8
*721.9
722.0
*722.1
722.2
722.3
722.4
*722.5
722.6
*722.7
*722.8
*722.9
723.0
723.1
723.2
723.3
723.4
723.5
723.6
723.7
723.8
723.9
*724.0
724.1
724.2
724.3
724.4
724.5
724.6
*724.7
724.8
724.9
725
728.0
*728.1
728.2
728.3
728.4
728.5
728.6
*728.7
*728.8
728.9
*730.0
*730.1
*730.2
*730.3
*730.9
731.0
731.2
732.0
732.1
732.2
732.3
732.4
732.5
732.6
732.7
732.8
732.9
781.0
781.1
781.2
781.3
781.4
781.5
781.6
781.7
781.8
*781.9
*800
*801
*802
*803
*804
*805
*806
*807
*808
*809
*810
*811
*812
*813
*814
*815
*816
*817
*818
*819
*820
*821
*822
*823
*824
*825
*827
*828
*831
*832
*833
*835
*836
*837
*838
*846
*847
*887
*896
*927
*928
Secondary Diagnoses
*711.1
*711.2
*711.3
*711.4
*711.5
*711.6
*711.7
*711.8
*712.1
*712.2
*712.3
713.0
713.1
713.2
713.3
713.4
713.5
713.6
713.7
713.8
720.81
*730.7
*730.8
731.1
731.8
Neurology
Primary Diagnoses
*013
*045
*046
*047
048
*049
*191
*192
*225
320.0
320.1
320.2
320.3
320.81
320.82
320.89
320.9
*322
323.5
323.8
323.9
*324
325
326
330.0
330.1
330.8
330.9
331.0
331.11
331.19
331.2
331.3
331.4
331.81
331.82
331.89
331.9
332.0
332.1
*333
2006 ICD•9•CM