2025 ICD-10-CM code I32
(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
Pericarditis occurring in the context of another, already-coded disease.
Modifiers may be applicable depending on the circumstances of the encounter and the underlying condition. Consult the CPT and ICD-10-CM guidelines for appropriate modifier usage.
The medical necessity for coding I32 hinges on the presence of a documented underlying disease.The pericarditis must be a direct result of the underlying condition.Sufficient clinical evidence must support the diagnosis of both conditions, demonstrating the appropriate causal link.
The clinical responsibility involves identifying and documenting the underlying disease causing the pericarditis, ensuring correct sequencing of codes for accurate billing and reimbursement. The physician must thoroughly document the clinical findings related to both the underlying condition and the pericarditis.
In simple words: This code is for inflammation of the sac around the heart (pericarditis) when it's caused by another illness. The doctor will code the main illness first and then add this code to show the pericarditis.
This code, I32, signifies pericarditis that arises as a complication or manifestation of a different underlying disease.It's crucial to note that the underlying condition must be coded first, followed by I32.Examples of underlying conditions that could lead to pericarditis include bacterial infections, other infectious diseases, systemic lupus erythematosus, and tuberculosis. The use of this code necessitates the presence of a primary code for the underlying disease, emphasizing that I32 represents the secondary condition of pericarditis.
Example 1: A patient with a history of systemic lupus erythematosus presents with chest pain and pericardial friction rub.The physician diagnoses lupus pericarditis.The code I32 would be used in addition to the code for systemic lupus erythematosus., A patient with a bacterial infection develops pericarditis as a complication. The underlying infection's code must be listed first, followed by I32 to indicate pericarditis., A patient with tuberculosis experiences pericardial inflammation.The code for tuberculosis must be sequenced before I32, reflecting the underlying cause of the pericarditis.
Comprehensive documentation is crucial.This should include the complete history and physical examination, diagnostic tests (e.g., electrocardiogram, echocardiogram), and any other relevant investigations which confirm the presence of pericarditis and, most importantly, the underlying disease that led to the condition.Detailed notes outlining the causal relationship between the underlying illness and the pericarditis are essential.
** This code is not a stand-alone diagnosis; a primary diagnosis code for the underlying condition must always be included.
- Payment Status: Active
- Modifier TC rule: Not applicable to this ICD-10 code.
- Specialties:Cardiology, Rheumatology, Infectious Disease
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office