ICD-10-CM Code I43

Valid for Submission

I43 is a billable code used to specify a medical diagnosis of cardiomyopathy in diseases classified elsewhere. The code is valid for the fiscal year 2021 for the submission of HIPAA-covered transactions. The ICD-10-CM code I43 might also be used to specify conditions or terms like cardiac glycogen phosphorylase kinase deficiency, cardiomyopathy associated with another disorder, cardiomyopathy in duchenne muscular dystrophy, cardiomyopathy in friedreich's ataxia, cardiomyopathy in myotonic dystrophy, diabetic cardiomyopathy, etc

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code I43:

Code First

Code First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.

• underlying disease, such as:
• amyloidosis E85
• glycogen storage disease E74.0
• gout M10.0
• thyrotoxicosis E05.0 E05.9

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

• cardiomyopathy (in):
• coxsackie virus B33.24
• diphtheria A36.81
• sarcoidosis D86.85
• tuberculosis A18.84

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

• Manifestation diagnoses - Manifestation codes describe the manifestation of an underlying disease, not the disease itself, and therefore should not be used as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Cardiac glycogen phosphorylase kinase deficiency
• Cardiomyopathy associated with another disorder
• Cardiomyopathy in Duchenne muscular dystrophy
• Cardiomyopathy in Friedreich's ataxia
• Cardiomyopathy in myotonic dystrophy
• Diabetic cardiomyopathy
• Dilated cardiomyopathy associated with connective tissue disorder
• Dilated cardiomyopathy secondary to systemic lupus erythematosus
• Familial cardiomyopathy
• Familial cardiomyopathy
• Familial non-neuropathic amyloidosis
• Familial restrictive cardiomyopathy
• Familial restrictive cardiomyopathy
• Glycogen phosphorylase kinase deficiency
• Glycogen phosphorylase kinase deficiency, autosomal recessive
• Glycogen storage disease with severe cardiomyopathy due to glycogenin deficiency
• Myocardial degeneration
• Primary eosinophilic endomyocardial cardiomyopathy
• Primary eosinophilic endomyocardial restrictive cardiomyopathy
• Primary restrictive cardiomyopathy
• Restrictive cardiomyopathy secondary to familial storage disease
• Restrictive cardiomyopathy with endomyocardial fibrosis
• Thyrotoxic heart disease
• Transthyretin related familial amyloid cardiomyopathy

Diagnostic Related Groups

The ICD-10 code I43 is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2021.

• 314 - OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC
• 315 - OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC
• 316 - OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Convert I43 to ICD-9

• 425.8 - Cardiomyopath in oth dis (Approximate Flag)

Code Classification

• Diseases of the circulatory system (I00–I99)
  • Other forms of heart disease (I30-I52)
    • Cardiomyopathy in diseases classified elsewhere (I43)

Code History

• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
  (First year ICD-10-CM implemented into the HIPAA code set)
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021

Tools

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• Convert I43 to ICD-9