Information for Patients
What is Chagas disease?
Chagas disease, or American trypanosomiasis, is an illness that can cause serious heart and stomach problems. It is caused by a parasite. Chagas disease is common in Latin America, especially in poor, rural areas. It can also be found in the United States, most often in people who were infected before they moved to the U.S.
What causes Chagas disease?
Chagas disease is caused by the Trypanosoma cruzi parasite. It is usually spread by infected blood-sucking bugs called triatomine bugs. They are also known as "kissing bugs" because they often bite people's faces. When of these bugs bites you, it leaves behind infected waste. You can become infected if you rub the waste in your eyes or nose, the bite wound, or a cut.
Chagas disease can also spread through contaminated food, a blood transfusion, a donated organ, or from mother to baby during pregnancy.
Who is at risk for Chagas disease?
Kissing bugs can be found throughout the Americas, but they are more common in certain areas. The people who are most at risk for Chagas disease:
- Live in rural areas of Latin America
- Have seen the bugs, especially in those areas
- Have stayed in a house with a thatched roof or with walls that have cracks or crevices
What are the symptoms of Chagas disease?
In the beginning, there may be no symptoms. Some people do get mild symptoms, such as:
- Body aches
- Loss of appetite
- A rash
- A swollen eyelid
These early symptoms usually go away. However, if you don't treat the infection, it stays in your body. Later, it can cause serious intestinal and heart problems such as:
- An irregular heartbeat that can cause sudden death
- An enlarged heart that doesn't pump blood well
- Problems with digestion and bowel movements
- An increased chance of having a stroke
How is Chagas disease diagnosed?
A physical exam and blood tests can diagnose it. You may also need tests to see whether the disease has affected your intestines and heart.
What are the treatments for Chagas disease?
Medicines can kill the parasite, especially early on. You can also treat related problems. For example, a pacemaker helps with some heart complications.
Can Chagas disease be prevented?
There are no vaccines or medicines to prevent Chagas disease. If you travel to areas where it occurs, you are at higher risk if you sleep outdoors or are staying in poor housing conditions. It is important to use insecticides to prevent bites and practice food safety.
Centers for Disease Control and Prevention
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- 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.
- Type 1 Excludes Notes - 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.
- Type 2 Excludes Notes - 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.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.