M32.11 - Endocarditis in systemic lupus erythematosus

Approximate Synonyms

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

• Disorder of heart due to systemic lupus erythematosus
• Endocarditis associated with another disorder
• Endocarditis due to systemic lupus erythematosus
• Nonbacterial verrucal endocardiosis

Diagnostic Related Groups - MS-DRG Mapping

The is diagnosis code is grouped in the following groups for version MS-DRG V40.0 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 10/01/2022 through 09/30/2023.

Convert to ICD-9 Code

Patient Education

Endocarditis

What is endocarditis?

Endocarditis is sometimes called infective endocarditis. It's a rare, but life-threatening inflammation of the lining inside your heart's chambers and valves (the endocardium).

Endocarditis is usually caused by germs that get into your bloodstream and travel to your heart. Once they get inside your heart, the germs can attach to the lining or get trapped in the valves. They start to grow, causing an infection. If not treated quickly, the infection can cause damage to the heart and lead to serious health problems.

What causes endocarditis?

Bacterial infections cause most endocarditis. Normally, many bacteria live in your mouth, on your skin, or in other parts of the body. Sometimes the bacteria can get into your bloodstream from injuries such cuts or scrapes. Dental work and certain surgeries can also allow small amounts of bacteria to enter your bloodstream.

In some cases, fungal infections cause endocarditis. The fungi, such as yeast, can live in parts of your body. Fungal infections generally happen in people who have weakened immune systems that can't stop the fungus from growing. This includes people who have HIV/AIDS.

Who is more likely to develop endocarditis?

In general, endocarditis is rare. If you're healthy, your immune system usually destroys the germs in your bloodstream before they can cause harm.

But your chance of developing endocarditis may be higher than most people if you:

• Have certain heart conditions. Damaged or abnormal heart tissue and devices in your heart can trap germs more easily than healthy heart tissue. That means your risk of endocarditis is higher if you have:
  • Heart valve disease.
  • Certain congenital heart defects.
  • A pacemaker or an implantable defibrillator.
  • A heart valve replacement.
• Are older. Age-related changes to the heart valves, such as mitral valve prolapse or calcium deposits in the aortic valve, create places for germs to attach to the heart.
• Inject illegal drugs. Unclean needles may carry bacteria into the bloodstream.
• Have a condition that weakens your immune system.
• Don't take care of your teeth and gums. Poor dental health makes it easier for germs to get into your bloodstream through your gums and mouth.
• Have a long-term central venous line, a tube that stays in a large vein for weeks or months for medical treatment.
• Have already had endocarditis. Endocarditis can damage heart tissue, which increases your risk of getting it again.

What are the symptoms of endocarditis?

Endocarditis symptoms may be severe or very mild. They may start suddenly or slowly. And they can vary from person to person. The possible symptoms of endocarditis include:

• Fever and chills
• New or worsening heart murmur (an unusual sound heard between heartbeats)
• Chest pain
• Cough
• Muscle, joint, and back pain
• Night sweats (heavy sweating during sleep)
• Shortness of breath (feeling like you can't get enough air)
• Skin changes, including:
  • Broken blood vessels
  • Painful red or purple bumps
  • Painless flat red spots on the palms of your hands or soles of your feet

What other problems can endocarditis cause?

When the germs are in your heart, they can clump together with blood cells. These clumps can break off and travel through your bloodstream. They may block blood flow, spread infection, or damage your organs, including your brain, lungs, kidneys, and spleen.

Endocarditis may sometimes lead to sepsis, a medical emergency that happens when your body has an extreme response to the infection.

Endocarditis can also cause serious heart problems including:

• Heart valve damage
• Heart failure
• Arrhythmia (a problem with the rate or rhythm of your heartbeat)

How is endocarditis diagnosed?

To find out if you have endocarditis, your doctor will:

• Ask about your medical history, including your symptoms, recent illnesses, and other health conditions that affect your chance of developing endocarditis.
• Do a physical exam.
• Likely order tests, such as:
  • Blood tests to check for signs of infection, bacteria, or fungi in your blood.
  • Chest x-rays.
  • Heart tests.

What are the treatments for endocarditis?

If you have endocarditis, it's important to get treatment quickly. Treatments may include:

• Medicines
  • Antibiotics to treat bacterial infections. Antibiotics are usually started through an intravenous (IV) line in the hospital.
  • Antifungal medicine to treat fungal infections. Your doctor may suggest taking antifungal medicine for the rest of your life to prevent the infection from coming back.
• Heart surgery may be needed to repair or replace damaged valves and heart tissue. Surgery may also be done to remove infected tissue.
• Dental care, especially cleanings, can help reduce the amount of bacteria that grows in your mouth.

Treatment may last weeks, and you may need tests to make sure it's working. Your doctor will also check you for problems that could develop from endocarditis, such as heart failure or an irregular heartbeat.

Can endocarditis be prevented?

If you have a higher chance of developing endocarditis than most people, you can reduce your risk if you:

• Take good care of your teeth and gums every day
• Have dental exams and cleaning at your dentist's office every 6 months
• Make heart-healthy habits part of your daily life to help prevent heart disease
• Call your health care provider right away if you have symptoms that could be endocarditis

People with the highest risk for bacterial endocarditis need antibiotics before dental visits or certain medical or surgical procedures. Ask your provider if you're part of the highest risk group. If so, let all your providers know about your risk.

NIH: National Heart, Lung, and Blood Institute

Lupus

What is lupus?

Lupus is an autoimmune disease. This means that your immune system attacks healthy cells and tissues by mistake. This can damage many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.

There are several kinds of lupus:

• Systemic lupus erythematosus (SLE) is the most common type. It can be mild or severe and can affect many parts of the body.
• Discoid lupus causes a red rash that doesn't go away
• Subacute cutaneous lupus causes sores after being out in the sun
• Drug-induced lupus is caused by certain medicines. It usually goes away when you stop taking the medicine.
• Neonatal lupus, which is rare, affects newborns. It is probably caused by certain antibodies from the mother.

What causes lupus?

The cause of lupus is unknown.

Who is at risk for lupus?

Anyone can get lupus, but women are most at risk. Lupus is two to three times more common in African American women than in white women. It's also more common in Hispanic, Asian, and Native American women. African American and Hispanic women are more likely to have severe forms of lupus.

What are the symptoms of lupus?

Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are:

• Pain or swelling in joints
• Muscle pain
• Fever with no known cause
• Red rashes, most often on the face (also called the "butterfly rash")
• Chest pain when taking a deep breath
• Hair loss
• Pale or purple fingers or toes
• Sensitivity to the sun
• Swelling in legs or around eyes
• Mouth ulcers
• Swollen glands
• Feeling very tired

Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time.

How is lupus diagnosed?

There is no specific test for lupus, and it's often mistaken for other diseases. So it may take months or years for a doctor to diagnose it. Your doctor may use many tools to make a diagnosis:

• Medical history
• Complete exam
• Blood tests
• Skin biopsy (looking at skin samples under a microscope)
• Kidney biopsy (looking at tissue from your kidney under a microscope)

What are the treatments for lupus?

There is no cure for lupus, but medicines and lifestyle changes can help control it.

People with lupus often need to see different doctors. You will have a primary care doctor and a rheumatologist (a doctor who specializes in the diseases of joints and muscles). Which other specialists you see depends on how lupus affects your body. For example, if lupus damages your heart or blood vessels, you would see a cardiologist.

Your primary care doctor should coordinate care between your different health care providers and treat other problems as they come up. Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it is working. You should report new symptoms to your doctor right away so that your treatment plan can be changed if needed.

The goals of the treatment plan are to:

• Prevent flares
• Treat flares when they occur
• Reduce organ damage and other problems

Treatments may include drugs to:

• Reduce swelling and pain
• Prevent or reduce flares
• Help the immune system
• Reduce or prevent damage to joints
• Balance the hormones

Besides taking medicines for lupus, you may need to take medicines for problems that are related to lupus such as high cholesterol, high blood pressure, or infection.

Alternative treatments are those that are not part of standard treatment. At this time, no research shows that alternative medicine can treat lupus. Some alternative or complementary approaches may help you cope or reduce some of the stress associated with living with a chronic illness. You should talk to your doctor before trying any alternative treatments.

How can I cope with lupus?

It is important to take an active role in your treatment. It helps to learn more about lupus - being able to spot the warning signs of a flare can help you prevent the flare or make the symptoms less severe.

It is also important to find ways to cope with the stress of having lupus. Exercising and finding ways to relax may make it easier for you to cope. A good support system can also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)