ICD-10-CM Code I52

Valid for Submission

I52 is a billable code used to specify a medical diagnosis of other heart disorders 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 I52 might also be used to specify conditions or terms like diffuse disease of coronary artery, ectatic coronary artery, luminal irregularities of coronary artery, mild intimal coronary irregularities without significant stenoses, restenotic lesion of coronary artery, subpulmonary stenosis, 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 I52:

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:
• congenital syphilis A50.5
• mucopolysaccharidosis E76.3
• schistosomiasis B65.0 B65.9

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.

• heart disease (in):
• gonococcal infection A54.83
• meningococcal infection A39.50
• rheumatoid arthritis M05.31
• syphilis A52.06

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:

• Diffuse disease of coronary artery
• Ectatic coronary artery
• Luminal irregularities of coronary artery
• Mild intimal coronary irregularities without significant stenoses
• Restenotic lesion of coronary artery
• Subpulmonary stenosis
• Ulcerated lesion of coronary artery

Diagnostic Related Groups

The ICD-10 code I52 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.

• 302 - ATHEROSCLEROSIS WITH MCC
• 303 - ATHEROSCLEROSIS WITHOUT MCC

Convert I52 to ICD-9

• 429.9 - Heart disease NOS (Approximate Flag)

Code Classification

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

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 I52 to ICD-9