There are multiple cardiovascular conditions associated with Hierarchical Condition Category (HCC) codes. Risk adjustment hierarchies exist between some of these conditions. This reinforces the importance of clear, specific and accurate documentation and coding at the time of evaluation and management services by providers. Never select a code more descriptive than your documentation! Condition specific coding details are outlined in this document.
Bradycardia, tachycardia and palpitations are not associated with a HCC.
Documentation should indicate what is being used to treat angina, and response to treatment, even if the condition is stable.
Date of the MI – acute MI is coded for 4 weeks following the event. Diagnosis becomes old MI (which does not risk adjust) at 4 weeks 1 day.
Hypertension is no longer identified as benign or malignant in ICD 10. There are no distinctions for controlled or uncontrolled.
Location – endocarditis, right ventricle, etc.
List cardiomyopathy seen in other diseases such as gout, amyloidosis, thyrotoxicosis, etc.
Heart valve disease is not associated with a HCC code in the Medicare Advantage model. The following information will help you to accurately document and code heart valve disease following ICD 10 coding guidelines.
Type – insufficiency, prolapse, regurgitation, incompetence, stenosis, etc.