2025 ICD-10-CM code I45.2
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Other forms of heart disease (I30-I5A) Diseases of the circulatory system (I00-I99) Feed
Bifascicular block is a heart conduction defect affecting two of the three main fascicles below the atrioventricular node.
ICD-10-CM codes do not utilize modifiers. Modifiers are associated with CPT and HCPCS procedure codes.
Medical necessity for further evaluation and management of bifascicular block depends on the presence or absence of symptoms. Asymptomatic individuals may require only periodic monitoring. Symptomatic patients require evaluation to assess for progression to complete heart block and to address the underlying cause.Electrophysiology study (EPS) may be medically necessary to assess the risk of complete heart block in symptomatic patients or high risk patients.
Diagnosis and management of bifascicular block typically involves a cardiologist. This may include ECG interpretation, further investigation of underlying causes (e.g., echocardiography, cardiac catheterization), monitoring for progression to complete heart block, and management of symptoms (e.g., medication or pacemaker implantation).
In simple words: Bifascicular block is a problem with the heart's electrical system.It means that two of the pathways that carry electrical signals to the heart's lower chambers aren't working properly. This can cause the heart to beat irregularly or too slowly.Sometimes, it's found incidentally; other times, it can cause symptoms such as fainting or dizziness.
Bifascicular block represents a conduction defect involving two of the three fascicles (branches) of the His-Purkinje system located beneath the atrioventricular (AV) node.This results in delayed or impaired transmission of electrical impulses to the ventricles, potentially leading to arrhythmias.It is typically diagnosed via electrocardiogram (ECG), showing a right bundle branch block (RBBB) combined with either a left anterior fascicular block (LAFB) or left posterior fascicular block (LPFB).The presence of bifascicular block can indicate underlying structural heart disease, and in some cases, may progress to complete heart block, necessitating intervention like pacemaker implantation.
Example 1: A 65-year-old male presents with unexplained syncope. ECG reveals a right bundle branch block with left anterior fascicular block (RBBB + LAFB), consistent with bifascicular block.Further workup may involve electrophysiology study (EPS) to assess risk of complete heart block., A 70-year-old female with a history of coronary artery disease experiences episodes of lightheadedness during exertion. ECG demonstrates bifascicular block.This might prompt further investigation for underlying ischemic heart disease or cardiac structural abnormalities., A 40-year-old asymptomatic individual undergoes an ECG as part of a routine checkup.Incidental finding of bifascicular block is discovered.Further evaluation is based on the patient's risk profile and the presence or absence of symptoms.Annual monitoring of ECG may be indicated.
* Detailed patient history, including symptoms (if any) such as syncope, dizziness, palpitations, or chest pain.* Complete physical examination findings.* Electrocardiogram (ECG) demonstrating the characteristic pattern of bifascicular block (RBBB with LAFB or LPFB).* Results of any further diagnostic testing, such as echocardiogram, cardiac catheterization, or electrophysiology study (EPS), if performed.* Documentation of medical decision-making justifying the level of service.
** This code should be used only when ECG findings clearly demonstrate a bifascicular block.The associated clinical presentation should be considered when selecting additional diagnoses.
- Revenue Code: Revenue codes will vary based on the specific services rendered and the healthcare provider's billing practices. Consult your facility's revenue code system for accurate mapping.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by other factors like place of service, provider type, and payer-specific rules.
- Global Days : Not applicable to ICD-10 codes. Global days are relevant to surgical CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10-CM codes.
- Fee Schedule : Not applicable to ICD-10-CM codes. Fee schedules are associated with CPT and HCPCS codes.
- Specialties:Cardiology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital, Ambulatory Surgical Center