2025 ICD-10-CM code I51.8
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Other forms of heart disease Diseases of the circulatory system (I00-I99) Feed
Other ill-defined heart diseases.
Modifiers may be applicable depending on the circumstances of the encounter. Consult the appropriate modifier guidelines for more specific scenarios.
Medical necessity for this code is established when a comprehensive clinical evaluation fails to clarify the type of heart disease, and other diagnoses are ruled out. The documentation must support this determination, indicating why a specific diagnosis cannot be made based on available data.
The clinical responsibility for assigning this code rests with the physician or other qualified healthcare professional who has conducted a thorough examination and determined that a more specific diagnosis cannot be made. It requires detailed clinical evaluation, including history, physical examination, laboratory tests, and imaging studies to rule out other conditions.
- Diseases of the circulatory system (I00-I99)
- I51 (Complications and ill-defined descriptions of heart disease)
In simple words: This code is used when a doctor finds a problem with the heart but can't pinpoint the exact cause or type of heart disease.
This ICD-10-CM code classifies heart diseases that cannot be categorized into more specific diagnostic categories within the I51 range.It encompasses various cardiac conditions where the precise nature of the heart disease remains unclear or incompletely defined after a thorough clinical evaluation.This code includes acute or chronic carditis and pancarditis when not further specified.
Example 1: A patient presents with shortness of breath and chest pain, but cardiac imaging and lab tests reveal nonspecific abnormalities, leaving the exact cause of the symptoms inconclusive., An elderly patient with a history of cardiovascular disease experiences a sudden worsening of symptoms, but a comprehensive work-up fails to reveal a clear diagnosis beyond general heart disease., A patient undergoes a cardiac catheterization that shows abnormalities, however, additional investigations provide insufficient information to provide a specific diagnosis for the heart condition.
Complete medical history, physical examination findings, results of all relevant laboratory tests (e.g., cardiac biomarkers, complete blood count), and imaging studies (e.g., electrocardiogram, echocardiogram, cardiac MRI) are necessary to support the use of this code.Detailed documentation of the clinical evaluation process, including the reasoning behind the inability to assign a more specific diagnosis, is crucial.
** This code should be used cautiously and only when a thorough evaluation fails to reveal a more precise diagnosis. Regular reassessment is crucial to identify if more specific information becomes available, allowing for a code change to a more precise diagnostic classification.
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- Specialties:Cardiology, Internal Medicine, Family Medicine
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital, Ambulatory Surgical Center