2025 ICD-10-CM code I43
Cardiomyopathy in diseases classified elsewhere. Code first the underlying disease.
Medical necessity must be established by demonstrating the relationship between the underlying condition and cardiomyopathy, supported by clinical findings and diagnostic test results. Treatment is medically necessary to manage the symptoms and prevent complications.
The clinician is responsible for establishing the cause-and-effect relationship between the underlying disease and the cardiomyopathy. Comprehensive documentation should detail the patient's medical history, physical examination findings, and diagnostic test results.
In simple words: This code signifies a weakened heart muscle due to another diagnosed condition. It's essential to identify and treat the root cause alongside managing the heart condition.
Cardiomyopathy in diseases classified elsewhere. Code first underlying disease, such as: amyloidosis (E85.-), glycogen storage disease (E74.0-), gout (M10.0-), thyrotoxicosis (E05.0-E05.9-). Excludes1: cardiomyopathy (in): coxsackie (virus) (B33.24), diphtheria (A36.81), sarcoidosis (D86.85), tuberculosis (A18.84)
Example 1: A patient with long-standing, poorly controlled diabetes develops heart failure symptoms. After an echocardiogram, the diagnosis is diabetic cardiomyopathy., A patient diagnosed with amyloidosis presents with shortness of breath and fatigue. Diagnostic testing reveals cardiac involvement, specifically amyloid cardiomyopathy., A patient receiving chemotherapy for cancer subsequently develops signs of heart failure, diagnosed as chemotherapy-induced cardiomyopathy.
Documentation should include evidence of the primary disease causing the cardiomyopathy, such as laboratory test results, imaging studies, or specialist consultations. The type and severity of the cardiomyopathy (e.g., dilated, restrictive, hypertrophic) should be documented.
** Accurate coding requires careful consideration of the causal relationship between the underlying disease and the cardiomyopathy. Appropriate documentation and coding ensure correct reporting and facilitate optimal patient management.
- Specialties:Cardiology, Internal Medicine, Family Medicine, Oncology (for chemotherapy-induced cardiomyopathy)
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Independent Clinic