Basics of ICD-10 code for Angina
Angina pectoris (category I20) is an early manifestation of ischemic heart disease; however, in rare instances, it occurs as a result of congenital abnormalities of the coronary arteries or such conditions as aortic stenosis, valvular insufficiency, aortic syphilis, or Raynaud’s phenomenon. It is characterized by chest pain (usually perceived by the patient as a sensation of tightness, squeezing, pressing, choking, or burning), heartburn or gas, or an ill-defined discomfort. The pain is similar to that of unstable angina, but it is less severe, more easily controlled, and usually relieved in a predictable manner by either rest or the administration of nitroglycerin.
Angina pectoris can be produced by any activity or situation that increases the oxygen requirements of the myocardium, such as exercise, walking into the wind, cold weather, consumption of a large meal, emotional stress, or elevation of blood pressure. Angina pectoris may also occur even when the patient is at rest and without apparent stimulation, such as during the night. This condition is referred to as nocturnal or decubitus angina and is classified as I20.8. A variant type that also occurs at rest is known as Prinzmetal angina. Angina described as angiospastic, Prinzmetal, spasm induced, or variant is coded to I20.1, Angina pectoris with documented spasm. ICD 10 Code I20.8, Other forms of angina pectoris, includes stable angina, angina equivalent, angina of effort, and stenocardia. Symptoms associated with angina equivalent are assigned additional codes.
In today’s health care environment, it is unlikely that a patient would be admitted to the hospital for treatment of stable angina except for the purpose of undergoing diagnostic studies to determine its underlying cause. In this case, sequence the combination code (I25.1-) for angina with atherosclerotic heart disease (ASHD) as the principal diagnosis when the ASHD is the underlying cause.
ICD 10 Code I20.0, Unstable angina, includes conditions described as accelerated angina, crescendo angina, de novo effort angina, intermediate coronary syndrome, preinfarction angina, or worsening effort angina. These conditions occur after less exertion has been expended than in angina pectoris; the pain is more severe and less easily relieved by nitroglycerin. Without treatment, unstable angina often progresses to acute myocardial infarction.
Code I20.0 is designated as the principal diagnosis only when the underlying condition is not identified and there is no surgical intervention. Patients with severe coronary arteriosclerosis and unstable angina may be admitted for cardiac bypass surgery or a percutaneous transluminal coronary angioplasty to prevent further progression to infarction. In such cases, the combination code for coronary arteriosclerosis with unstable angina (I25.110) is assigned as the principal diagnosis.
Signs and symptoms
Angina is not a disease but a symptom of an underlying heart problem, typically coronary heart disease. It can feel like pressure or squeezing in one’s chest.
Types
There are four types of angina:
- Microvascular angina- chest pain usually lasting longer than 10 minutes, and sometimes longer than 30 minutes
- Stable angina- chest pain due to coronary heart disease
- Unstable angina- unexpected chest pain, usually while resting
- Variant angina- spasms that occur when the person is resting
Treatment
Treatment for angina includes:
- Cardiac procedures– angioplasty or bypass surgery
- Cardiac rehab- a medically supervised program designed to help improve your cardiovascular health
- Lifestyle changes- quitting smoking, engaging in physical activity every day, etc.
- Medicine- anticoagulants, beta blockers
ICD-10-CM coding forAngina
The following ICD-10-CM codes are used to report angina:
- I20.1, angina with documented spasm
- I20.9, angina (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor)
