Not Valid for Submission
I46 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of cardiac arrest. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.
Specific Coding for Cardiac arrest
Non-specific codes like I46 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for cardiac arrest:
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 coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code I46:
Type 2 ExcludesType 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- cardiogenic shock R57.0
- HEART ARREST-. cessation of heart beat or myocardial contraction. if it is treated within a few minutes heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.
- HEART ARREST INDUCED-. a procedure to stop the contraction of myocardium during heart surgery. it is usually achieved with the use of chemicals cardioplegic solutions or cold temperature such as chilled perfusate.
- DEATH SUDDEN CARDIAC-. unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. it is usually caused by the worsening of existing heart diseases. the sudden onset of symptoms such as chest pain and cardiac arrhythmias particularly ventricular tachycardia can lead to the loss of consciousness and cardiac arrest followed by biological death. from braunwald's heart disease: a textbook of cardiovascular medicine 7th ed. 2005
- OUT OF HOSPITAL CARDIAC ARREST-. occurrence of heart arrest in an individual when there is no immediate access to medical personnel or equipment.
Information for Patients
Sudden Cardiac Arrest
What is sudden cardiac arrest (SCA)?
Sudden cardiac arrest (SCA) is a condition in which the heart suddenly stops beating. When that happens, blood stops flowing to the brain and other vital organs. If it is not treated, SCA usually causes death within minutes. But quick treatment with a defibrillator may be lifesaving.
How is sudden cardiac arrest (SCA) different from a heart attack?
A heart attack is different from an SCA. A heart attack happens when blood flow to the heart is blocked. During a heart attack, the heart usually doesn't suddenly stop beating. With an SCA, the heart stops beating.
Sometimes an SCA can happen after or during recovery from a heart attack.
What causes sudden cardiac arrest (SCA)?
Your heart has an electrical system that controls the rate and rhythm of your heartbeat. An SCA can happen when the heart's electrical system is not working right and causes irregular heartbeats. Irregular heartbeats are called arrhythmias. There are different types. They may cause the heart to beat too fast, too slow, or with an irregular rhythm. Some can cause the heart to stop pumping blood to the body; this is the type that causes SCA.
Certain diseases and conditions can cause the electrical problems that lead to SCA. They include
- Ventricular fibrillation, a type of arrhythmia where the ventricles (the heart's lower chambers) don't beat normally. Instead, they beat very fast and very irregularly. They can't pump blood to the body. This causes most SCAs.
- Coronary artery disease (CAD), also called ischemic heart disease. CAD happens when the arteries of the heart cannot deliver enough oxygen-rich blood to the heart. It is often caused by the buildup of plaque, a waxy substance, inside the lining of larger coronary arteries. The plaque blocks some or all of the blood flow to the heart.
- Some types of physical stress can cause your heart's electrical system to fail, such as
- Intense physical activity in which your body releases the hormone adrenaline. This hormone can trigger SCA in people who have heart problems.
- Very low blood levels of potassium or magnesium. These minerals play an important role in your heart's electrical system.
- Major blood loss
- Severe lack of oxygen
- Certain inherited disorders which can cause arrhythmias or problems with the structure of your heart
- Structural changes in the heart, such as an enlarged heart due to high blood pressure or advanced heart disease. Heart infections can also cause changes to the structure of the heart.
Who is at risk for sudden cardiac arrest (SCA)?
You are at higher risk for SCA if you
- Have coronary artery disease (CAD). Most people with SCA have CAD. But CAD usually doesn't cause symptoms, so they may not know that they have it.
- Are older; your risk increases with age
- Are a man; it is more common in men than women
- Are Black or African American, especially if you have other conditions such as diabetes, high blood pressure, heart failure, or chronic kidney disease
- Have a personal history of heartbeats that aren't regular (arrhythmia)
- Have a personal or family history of SCA or inherited disorders that can cause arrhythmia
- Have a problem with drug or alcohol use
- Have had a heart attack
- Have heart failure
What are the symptoms of sudden cardiac arrest (SCA)?
Usually, the first sign of SCA is loss of consciousness (fainting). This happens when the heart stops beating.
Some people may have a racing heartbeat or feel dizzy or light-headed just before they faint. And sometimes people have chest pain, shortness of breath, nausea, or vomiting in the hour before they have an SCA.
How is sudden cardiac arrest (SCA) diagnosed?
SCA happens without warning and requires emergency treatment. Health care providers rarely diagnose SCA with medical tests as it's happening. Instead, it is usually diagnosed after it happens. Providers do this by ruling out other causes of a person's sudden collapse.
If you are at high risk for SCA, your provider may refer you to a cardiologist, a doctor who specializes in heart diseases. The cardiologist may ask you to get various heart health tests to see how well you heart is working. He or she will work with you to decide whether you need treatment to prevent SCA.
What are the treatments for sudden cardiac arrest (SCA)?
SCA is an emergency. A person having SCA needs to be treated with a defibrillator right away. A defibrillator is a device sends an electric shock to the heart. The electric shock can restore a normal rhythm to a heart that's stopped beating. To work well, it needs to be done within minutes of the SCA.
Most police officers, emergency medical technicians, and other first responders are trained and equipped to use a defibrillator. Call 9-1-1 right away if someone has signs or symptoms of SCA. The sooner you call for help, the sooner lifesaving treatment can begin.
What should I do if I think that someone has had an SCA?
Many public places such as schools, businesses, and airports have automated external defibrillators (AEDs). AEDs are special defibrillators that untrained people can use if they think that someone has had SCA. AEDS are programmed to give an electric shock if they detect a dangerous arrhythmia. This prevents giving a shock to someone who may have fainted but isn't having SCA.
If you see someone who you think has had SCA, you should give cardiopulmonary resuscitation (CPR) until defibrillation can be done.
People who are at risk for SCA may want to consider having an AED at home. Ask your cardiologist to help you decide whether having an AED in your home might help you.
What are the treatments after surviving sudden cardiac arrest (SCA)?
If you survive SCA, you'll likely be admitted to a hospital for ongoing care and treatment. In the hospital, your medical team will closely watch your heart. They may give you medicines to try to reduce the risk of another SCA.
They will also try to find out what caused your SCA. If you're diagnosed with coronary artery disease, you may have an angioplasty or coronary artery bypass surgery. These procedures help restore blood flow through narrowed or blocked coronary arteries.
Often, people who have had SCA get a device called an implantable cardioverter defibrillator (ICD). This small device is surgically placed under the skin in your chest or abdomen. An ICD uses electric pulses or shocks to help control dangerous arrhythmias.
Can sudden cardiac arrest (SCA) be prevented?
You may be able to lower your risk of SCA by following a heart-healthy lifestyle. If you have coronary artery disease or another heart disease, treating that disease can also lower your risk of SCA. If you have had an SCA, getting an implantable cardioverter defibrillator (ICD) can lower your chance of having another SCA.
NIH: National Heart, Lung, and Blood Institute
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