2025 ICD-10-CM code A18.84
(Active) Effective Date: N/A Infectious and Parasitic Diseases - Tuberculosis Certain infectious and parasitic diseases Feed
Tuberculosis of the heart.This encompasses tuberculous cardiomyopathy, endocarditis, myocarditis, and pericarditis.
Medical necessity for services related to A18.84 is established by the presence of signs, symptoms, and diagnostic findings consistent with tuberculosis of the heart. This includes symptoms like chest pain, shortness of breath, irregular heartbeat, fatigue and swelling in the legs. Diagnostic tests showing pericardial effusion or myocardial inflammation support the need for treatment and management of the condition.
Physicians, particularly cardiologists and infectious disease specialists, are responsible for diagnosing and managing tuberculosis of the heart.Diagnosis involves evaluating symptoms, medical history (including history of TB), conducting physical examinations, performing imaging studies (such as MRI, CT scans, and echocardiography), and obtaining tissue biopsies for histological analysis to confirm the presence of acid-fast bacilli. Treatment typically involves a multi-drug antituberculous chemotherapy regimen.
In simple words: Tuberculosis (TB) can sometimes affect the heart, although it's rare. This happens when the bacteria that cause TB spread from the lungs to the heart, causing inflammation and other problems.This can lead to different heart conditions depending on the part of the heart affected.
Tuberculosis of the heart is a rare manifestation of extrapulmonary tuberculosis affecting the heart's structures, including the myocardium (heart muscle), endocardium (inner lining), pericardium (outer sac), and coronary arteries.It results from the spread of Mycobacterium tuberculosis (and rarely Mycobacterium bovis) from a primary infection site, usually the lungs, to the heart, most commonly through hematogenous dissemination. The infection can lead to various cardiac complications such as pericarditis (inflammation of the pericardium), myocarditis (inflammation of the myocardium), endocarditis (inflammation of the endocardium), and the formation of tuberculomas (mass-like lesions).
Example 1: A patient with a history of pulmonary tuberculosis presents with chest pain, shortness of breath, and edema.Imaging studies reveal pericardial effusion, and a biopsy confirms tuberculous pericarditis., A patient with HIV and a history of untreated latent TB develops arrhythmias and signs of heart failure.Cardiac MRI reveals myocardial involvement, and a biopsy confirms tuberculous myocarditis., An immunocompromised patient presents with fever, night sweats, and weight loss.Echocardiography reveals a mass in the right atrium, and subsequent biopsy confirms a cardiac tuberculoma.
Documentation for A18.84 should include evidence of active TB infection, clinical findings suggestive of cardiac involvement (e.g., chest pain, abnormal heart sounds, arrhythmias, heart failure), imaging findings (e.g., pericardial effusion, myocardial thickening, tuberculomas), and histological confirmation from tissue biopsy showing the presence of acid-fast bacilli or granulomas consistent with TB.Previous history of TB,tuberculin skin test results and treatment received may also help to support code assignment.
** Tuberculosis of the heart is a serious condition associated with significant morbidity and mortality. Prompt diagnosis and treatment are essential to improve patient outcomes. Clinicians should maintain a high index of suspicion for cardiac TB in patients with a history of TB or those from endemic areas who present with cardiac symptoms.
- Specialties:Cardiology, Infectious Disease
- Place of Service:Inpatient Hospital, Outpatient Hospital