2025 ICD-10-CM code I97.1
Other postprocedural cardiac functional disturbances
Medical necessity for the evaluation and treatment of the postprocedural cardiac functional disturbance must be demonstrated.The documentation should support the need for interventions, such as medication management, further diagnostic testing, or other therapies, based on the severity of the disturbance and its impact on the patient's health.
Diagnosis and management of this condition falls under the purview of cardiology or cardiothoracic surgery, depending on the specific underlying procedure.The clinician is responsible for evaluating and treating the functional disturbance, which might include medication management, lifestyle modifications, or further interventions.
In simple words: This code refers to problems with how your heart works after you've had a procedure done on your heart, such as surgery.It's used when the problems aren't covered by a more specific code. For example, your heart might not beat as strongly or regularly as it should after surgery.
This code describes a range of functional disturbances affecting the heart that occur after a cardiac procedure.These disturbances are not otherwise classified under a more specific code. Examples might include irregular heartbeats, reduced pumping efficiency, or other functional issues following surgery or other interventions.
Example 1: A patient experiences irregular heartbeats and shortness of breath following valve replacement surgery. After ruling out other causes, the cardiologist diagnoses the patient with a postprocedural cardiac functional disturbance and adjusts medications to address the arrhythmia., A patient undergoing a cardiac catheterization procedure develops reduced ejection fraction post-procedure.This functional disturbance is documented using I97.1 and the patient is monitored closely for improvement., A patient who received a pacemaker experiences dizziness and lightheadedness following the procedure. After evaluation, these symptoms are attributed to a postprocedural functional disturbance related to the pacemaker's function, and adjustments are made to optimize the device's settings.
Documentation should clearly establish the relationship between the cardiac functional disturbance and the preceding cardiac procedure.Specific symptoms, diagnostic test results (such as ECG, echocardiogram), and the impact on the patient's functional status should be documented.It's important to rule out other potential causes of the symptoms before assigning this code.
** Excludes2 notes are specific instructions indicating when a code should *not* be used. For I97.1, it excludes acute pulmonary insufficiency following thoracic surgery (J95.1) and intraoperative cardiac functional disturbances (I97.7-). This means if the functional disturbance occurs during the surgery or is specifically related to pulmonary insufficiency after thoracic surgery, a different code should be used.The parent code, I97, also has an Excludes2 note for postprocedural shock (T81.1-), which would also apply to I97.1.
- Payment Status: Active
- Specialties:Cardiology, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital,Office, Ambulatory Surgical Center