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2025 ICD-10-CM code B57.2

Chronic Chagas disease with cardiac involvement, a complication of the infectious disease caused by Trypanosoma cruzi.

Use additional codes to specify the type of heart involvement (e.g., heart failure, arrhythmia). Also, code any other manifestations of Chagas disease affecting other organ systems.

The medical necessity for services related to B57.2 hinges on the presence of chronic Chagas disease causing cardiac manifestations that require medical intervention.The documentation should clearly establish the link between the Chagas disease and the cardiac condition, and justify the need for the specific services provided.

Diagnosis of Chagas disease with heart involvement is based on patient history (including possible exposure to kissing bugs or areas where the disease is common), physical examination, and laboratory tests. Laboratory testing may include microscopic examination of blood, serological tests to detect antibodies against T. cruzi, and PCR to detect the parasite's DNA. Other diagnostic tests may include electrocardiography (ECG) to assess heart rhythm abnormalities, echocardiography to visualize heart structure and function, and possibly cardiac MRI or other imaging studies.Treatment of chronic Chagas cardiomyopathy is complex and may involve medications to manage heart failure, arrhythmias, and thromboembolic events. Antiparasitic treatment is usually not indicated in the chronic stage, but consultation with an infectious disease specialist might be beneficial in specific cases.

In simple words: This code indicates long-term Chagas disease that affects the heart. Chagas disease is an infection spread by "kissing bugs." If the infection becomes chronic and impacts the heart, it can lead to problems like irregular heartbeats, heart inflammation, heart failure, blood clots, and stroke.

This code represents a chronic infection with Trypanosoma cruzi that has resulted in cardiac complications.Chagas disease is typically transmitted through the bite of triatomine insects (kissing bugs). Chronic Chagas disease can manifest years or even decades after the initial infection and involve various organs, including the heart, digestive system, and nervous system. When the heart is involved, patients can experience a range of cardiac issues, including irregular heartbeats, myocarditis (inflammation of the heart muscle), heart failure, thromboembolism (blood clots), and stroke.It is the leading cause of infectious myocarditis worldwide.

Example 1: A 45-year-old patient immigrated from South America presents with palpitations, shortness of breath, and fatigue.An ECG reveals arrhythmias, and echocardiography shows signs of cardiomyopathy. Serological tests confirm the presence of T. cruzi antibodies, leading to a diagnosis of chronic Chagas disease with heart involvement (B57.2)., A 60-year-old patient with a history of Chagas disease (diagnosed several years prior) now experiences worsening shortness of breath and swelling in their legs.Echocardiography reveals decreased heart function, consistent with heart failure due to chronic Chagas cardiomyopathy (B57.2)., A 30-year-old patient with a known history of Chagas disease presents with sudden onset of weakness on one side of the body and difficulty speaking.Imaging studies reveal a stroke. The patient's Chagas disease and associated cardiac involvement (B57.2) are considered contributing factors to the stroke, likely due to a thromboembolic event originating in the heart.

Documentation should include evidence of chronic Chagas disease (positive serology for T. cruzi, history of exposure), as well as specific details of the cardiac involvement, such as ECG findings, echocardiography results, and other relevant diagnostic studies.Symptoms, physical exam findings, and treatment plans should also be clearly documented.

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