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LCD Reference Article Billing and Coding Article

Billing and Coding: Cardiac Catheterization and Coronary Angiography

A52850

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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Source Article ID
N/A
Article ID
A52850
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Article Type
Billing and Coding
Original Effective Date
10/01/2015
Revision Effective Date
10/01/2024
Revision Ending Date
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Retirement Date
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Article Text

This article contains coding and other guidelines that complement the local coverage determination (LCD) for Cardiac Catheterization and Coronary Angiography.

Coding Guidelines:

Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare.

For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.

A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.

The diagnosis code(s) must best describe the patient’s condition for which the service was performed.

Specific coding guidelines:
Diagnosis Coding
A primary diagnosis of ICD-10-CM code Z09 (encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm); and a secondary diagnosis of ICD-10-CM code Z94.1 (heart transplant status); should be used for patients post-heart transplant requiring follow-up cardiac catheterization and not showing evidence of rejection.

Add the ICD-10-CM code for the underlying disorder (cause) for ICD-10-CM codes I25.82 (chronic total occlusion of coronary artery) and I31.4 (cardiac tamponade).

The CPT code(s) for the cardiac catheterization procedure(s), coronary angiography, and injection procedure(s) should be linked to the appropriate ICD-10-CM diagnosis code(s) that describes the indication for the procedure on the claim.

Modifier Guidelines
When billing for CPT codes 92978, 92979, 93571 and 93572, use the coronary artery modifier to identify which vessel is undergoing a specific procedure. The modifiers are RC: right coronary artery, LC: left circumflex coronary artery, LD: left anterior descending coronary artery, LM: left main coronary artery, and RI: ramus intermedius.

Claims for these services billed without the major artery modifier will be returned to the provider as unprocessable.

Coronary angiography procedures, performed during a therapeutic coronary artery procedure, that are integral parts of the procedure (e.g., guiding arteriograms), are considered to be part of the percutaneous coronary intervention and not separately reportable diagnostic procedures. However, when billing for a diagnostic cardiac catheterization or angiography, which has not been previously performed, but now is performed on the same day as a separate procedure prior to percutaneous coronary intervention, then the 59 modifier should be appended to the codes 93454 – 93461 as appropriate.

Not Separately Billable Services
The following services are included in cardiac catheterization and coronary angiography, and should not be separately billed to Medicare:

  • sedation;
  • local anesthesia;
  • positioning, repositioning, and removal of catheter(s);
  • recording of intravascular and intracardiac pressures;
  • obtaining blood samples for blood gas determinations;
  • cardiac output measurements at rest, or at rest and during exercise, with or without electrode catheter placement;
  • monitoring services, such as ECG and arterial oxygen saturation;
  • final evaluation;
  • written report;
  • administration of medications during catheterization to treat acute symptoms or adverse events (e.g., angina, congestion, arrhythmias, etc);
  • post-procedure evaluation.

Medicare Part B covers only the professional component of cardiac catheterization and coronary angiography procedures, when they are performed in hospital inpatient and outpatient facility settings. The technical component is covered under the Part A benefit. Diagnostic cardiac catheterization performed in an office setting (where permitted) is covered under Part B for both the professional and technical components.

CPT and Units of Service Guidelines
Catheterization for anomalous coronary arteries, patent foramen ovale, mitral valve prolapse and bicuspid aortic valve should be reported with the non-congenital catheterization codes (93451-93464 and 93566-93568).

Use CPT code 93541 or other appropriate right heart catheterization code (93453, 93456, 93457, 93460 or 93461) when right heart catheterization is done in a cardiac catheterization laboratory or in an interventional radiology laboratory and the procedure is done as part of a formal cardiac catheterization study.

The CPT codes for right heart catheterization are to be reported only when they pertain to diagnostic studies. Therefore, they should not be separately coded when a flow-directed catheter (e.g., Swan-Ganz) is placed in the right heart for monitoring purposes or when an endomyocardial biopsy is performed without obtaining hemodynamic data not previously available.

When an endomyocardial biopsy (CPT code 93505) is performed during cardiac catheterization, bill only one unit of service regardless of the number of biopsies taken.

CPT codes 93454 and 93455 (catheter placement, angiography) should be billed, as appropriate, when coronary or bypass angiography without left heart catheterization is performed. CPT codes 93454 and 93455 may be billed only once per catheterization.

CPT codes for Cardiac Catheterization include all dye injections for angiography, catheter insertion/replacement and repositioning, and the supervision and interpretation. Component services are no longer separately billable. Codes may be billed once per catheterization encounter.

CPT code 93598 may not be billed with catheterization codes.

When a catheterization involving multiple components is performed, the single CPT code including all of the components should be billed. Services for the individual component parts may not be billed. CPT codes 93563-93565 may only be billed with CPT codes 93593, 93594, 93595, 93596, and 93597. Codes for right atrial/ventricular angiography, supravalvular aortography and pulmonary angiography may be billed as add-on codes with any of the catheterization codes.

The transeptal/transapical left heart catheterization (93462) may be billed with 93452-93453, 93458-93461, 93595, 93596 and 93597. This code may only be billed when there is a puncture of an intact septum and should not be billed if the catheter is advanced into the left atrium through a patent foramen ovale or atrial septal defect.

Pharmacologic agent administration (93463) and Physiologic exercise study (93464) may only be coded when performed with pre-, intra- and post-intervention hemodynamic and function measures as a diagnostic test or to evaluate potential therapeutic interventions.

Percutaneous insertion of an intra-aortic balloon catheter may be coded separately when performed during the same encounter that cardiac catheterization or coronary angiography is performed.

The CPT codes for repair of blood vessel, direct (35201, 35206 and 35226) and repair of blood vessel with graft other than vein (35261, 35266 and 35286) are codes for open repairs of these vessels, and should not be used to bill for the use of percutaneous vascular closure devices (G0269) with angiographic, cardiac catheterization and interventional cardiology or radiology procedures.

Selective extra-cardiac angiography performed during cardiac catheterization, when medically necessary, should be billed using the appropriate codes from the 36140-36254 and 75625-75716 series. These codes should also be billed when these angiographic services are performed unrelated to cardiac catheterization.

Codes from 36140 through 36254 and 75625 through 75716 should only be coded if they are used to code selective studies and were medically necessary for diagnostic purposes as described in the LCD.

For claims submitted to the Part B MAC:

All services/procedures performed on the same day for the same beneficiary by the physician/provider should be billed on the same claim.

The insertion of the percutaneous closure device (G0269) is a bundled service and not separately billable by the physician.

The name and NPI of the treating physician who specifically requested/ordered extra-cardiac angiographic services must be submitted in items 17 and 17a of the CMS 1500 form or in the electronic equivalent of the claim for these services.

Supervision Criteria
The global and technical component [TC] procedures are covered under part B when performed under personal physician supervision (the physician would have to be present in the room while the entire cardiac catheterization is being performed) in the following circumstances:

  • The procedure is performed in an IDTF or free-standing facility;
  • The cardiac catheterization is performed in an entity set up as a physician office or physician directed clinic;

The professional components (-26) and professional services are reimbursable in any approved site of service when performed under personal physician supervision (the physician would have to be present in the room while the entire cardiac catheterization is being performed).

For claims submitted to the Part A MAC:

Cardiac catheterizations for which an overnight stay is anticipated, for routine recovery, should not be billed as inpatient services. Furthermore, the routine recovery period should not be billed as observation hours in addition to the catheterization unless the patient has sustained untoward complications necessitating the continued monitoring. An inpatient or observation stay following a routine outpatient cardiac catheterization would be considered not medically necessary and denied.

The insertion of the percutaneous closure device (G0269) is not a reimbursable service although it should be billed on the UB-92 claim but as a non-reimbursable supply (“N”status).

Documentation Requirements:

Each claim must be submitted with ICD-10-CM codes that reflect the condition of the patient, and indicate the reason(s) for which the service was performed. Claims submitted without ICD-10-CM codes will be returned.

The patient’s medical record should contain documentation that fully supports the medical necessity for cardiac catheterization and coronary angiography as it is covered by Medicare. This documentation includes, but is not limited to, relevant medical history, physical examination and results of pertinent diagnostic tests or procedures.

The medical record should contain a formal procedure report and interpretation for each procedure performed.

The record must include documentation of the medical decision making when interventional procedures are not performed during the same session as the diagnostic procedures.

The medical record must include documentation of the medical necessity for each procedure when multiple catheterization and angiographic procedures are performed during the same session.

The medical record must include an interpretation and report of all angiograms. Imaging for each angiographic procedure (film, video or digital) must be retained in the medical record and be available for review by the Medicare contractor.

The medical record must include documentation of request for extra-cardiac angiography from the referring/ordering provider treating the patient.

Medical records must be made available to Medicare upon request.

Utilization Guidelines:

Diagnostic coronary angiography may not be billed when performed during percutaneous coronary intervention, if it has been previously performed within the past six months resulting in the decision for the beneficiary to undergo the specific interventional procedure.

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Coding Information

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CPT/HCPCS Codes

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Group 1

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 Group 1 Codes

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ICD-10-CM Codes that Support Medical Necessity

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Group 1

(263 Codes)
Group 1 Paragraph

The use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the attached determination.

While there are no ICD-10 code lists for add-on codes within this Article, all coverage provisions for these services, as specified in the Indications and Limitations section of the LCD, must be followed for coverage to apply.

Right Heart Catheterization (CPT codes 93451, 93453, 93456, 93457. 93460, 93461)

 Group 1 Codes
Code Description
A18.84 Tuberculosis of heart
A39.50 Meningococcal carditis, unspecified
A39.51 Meningococcal endocarditis
A39.52 Meningococcal myocarditis
A52.03 Syphilitic endocarditis
A52.06 Other syphilitic heart involvement
A54.83 Gonococcal heart infection
A78 Q fever
B33.20 Viral carditis, unspecified
B33.21 Viral endocarditis
B33.22 Viral myocarditis
B37.6 Candidal endocarditis
B57.0 Acute Chagas' disease with heart involvement
B57.2 Chagas' disease (chronic) with heart involvement
C38.0 Malignant neoplasm of heart
C45.2 Mesothelioma of pericardium
D15.1 Benign neoplasm of heart
D86.85 Sarcoid myocarditis
D86.87 Sarcoid myositis
D86.9 Sarcoidosis, unspecified
E51.11 Dry beriberi
E51.12 Wet beriberi
E74.00 Glycogen storage disease, unspecified
E74.01 von Gierke disease
E74.02 Pompe disease
E74.03 Cori disease
E74.04 McArdle disease
E74.05 Lysosome-associated membrane protein 2 [LAMP2] deficiency
E74.09 Other glycogen storage disease
E74.4 Disorders of pyruvate metabolism and gluconeogenesis
E76.01 Hurler's syndrome
E76.02 Hurler-Scheie syndrome
E76.03 Scheie's syndrome
E76.1 Mucopolysaccharidosis, type II
E76.210 Morquio A mucopolysaccharidoses
E76.211 Morquio B mucopolysaccharidoses
E76.219 Morquio mucopolysaccharidoses, unspecified
E76.22 Sanfilippo mucopolysaccharidoses
E76.29 Other mucopolysaccharidoses
E76.3 Mucopolysaccharidosis, unspecified
E76.8 Other disorders of glucosaminoglycan metabolism
E76.9 Glucosaminoglycan metabolism disorder, unspecified
E84.0 Cystic fibrosis with pulmonary manifestations
E85.1 Neuropathic heredofamilial amyloidosis
E85.2 Heredofamilial amyloidosis, unspecified
E85.3 Secondary systemic amyloidosis
E85.4 Organ-limited amyloidosis
E85.81 Light chain (AL) amyloidosis
E85.82 Wild-type transthyretin-related (ATTR) amyloidosis
E85.89 Other amyloidosis
E85.9 Amyloidosis, unspecified
G11.11 Friedreich ataxia
G71.01 Duchenne or Becker muscular dystrophy
G71.02 Facioscapulohumeral muscular dystrophy
G71.09 Other specified muscular dystrophies
G71.11 Myotonic muscular dystrophy
I01.0 Acute rheumatic pericarditis
I01.1 Acute rheumatic endocarditis
I01.2 Acute rheumatic myocarditis
I01.8 Other acute rheumatic heart disease
I01.9 Acute rheumatic heart disease, unspecified
I05.0 Rheumatic mitral stenosis
I05.1 Rheumatic mitral insufficiency
I05.2 Rheumatic mitral stenosis with insufficiency
I05.8 Other rheumatic mitral valve diseases
I05.9 Rheumatic mitral valve disease, unspecified
I06.0 Rheumatic aortic stenosis
I06.1 Rheumatic aortic insufficiency
I06.2 Rheumatic aortic stenosis with insufficiency
I06.8 Other rheumatic aortic valve diseases
I06.9 Rheumatic aortic valve disease, unspecified
I07.0 Rheumatic tricuspid stenosis
I07.1 Rheumatic tricuspid insufficiency
I07.2 Rheumatic tricuspid stenosis and insufficiency
I07.8 Other rheumatic tricuspid valve diseases
I07.9 Rheumatic tricuspid valve disease, unspecified
I08.0 Rheumatic disorders of both mitral and aortic valves
I08.1 Rheumatic disorders of both mitral and tricuspid valves
I08.2 Rheumatic disorders of both aortic and tricuspid valves
I08.3 Combined rheumatic disorders of mitral, aortic and tricuspid valves
I08.8 Other rheumatic multiple valve diseases
I08.9 Rheumatic multiple valve disease, unspecified
I09.0 Rheumatic myocarditis
I09.1 Rheumatic diseases of endocardium, valve unspecified
I09.2 Chronic rheumatic pericarditis
I09.81 Rheumatic heart failure
I09.89 Other specified rheumatic heart diseases
I09.9 Rheumatic heart disease, unspecified
I11.0 Hypertensive heart disease with heart failure
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I23.1 Atrial septal defect as current complication following acute myocardial infarction
I23.2 Ventricular septal defect as current complication following acute myocardial infarction
I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction
I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction
I25.3 Aneurysm of heart
I26.01 Septic pulmonary embolism with acute cor pulmonale
I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale
I26.09 Other pulmonary embolism with acute cor pulmonale
I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale
I26.99 Other pulmonary embolism without acute cor pulmonale
I27.0 Primary pulmonary hypertension
I27.1 Kyphoscoliotic heart disease
I27.20 Pulmonary hypertension, unspecified
I27.21 Secondary pulmonary arterial hypertension
I27.22 Pulmonary hypertension due to left heart disease
I27.23 Pulmonary hypertension due to lung diseases and hypoxia
I27.24 Chronic thromboembolic pulmonary hypertension
I27.29 Other secondary pulmonary hypertension
I27.81 Cor pulmonale (chronic)
I27.82 Chronic pulmonary embolism
I27.83 Eisenmenger's syndrome
I27.89 Other specified pulmonary heart diseases
I27.9 Pulmonary heart disease, unspecified
I28.0 Arteriovenous fistula of pulmonary vessels
I28.1 Aneurysm of pulmonary artery
I28.8 Other diseases of pulmonary vessels
I28.9 Disease of pulmonary vessels, unspecified
I30.0 Acute nonspecific idiopathic pericarditis
I30.1 Infective pericarditis
I30.8 Other forms of acute pericarditis
I30.9 Acute pericarditis, unspecified
I31.0 Chronic adhesive pericarditis
I31.1 Chronic constrictive pericarditis
I31.2 Hemopericardium, not elsewhere classified
I31.31 Malignant pericardial effusion in diseases classified elsewhere
I31.39 Other pericardial effusion (noninflammatory)
I31.8 Other specified diseases of pericardium
I31.9 Disease of pericardium, unspecified
I32 Pericarditis in diseases classified elsewhere
I33.0 Acute and subacute infective endocarditis
I33.9 Acute and subacute endocarditis, unspecified
I34.0 Nonrheumatic mitral (valve) insufficiency
I34.1 Nonrheumatic mitral (valve) prolapse
I34.2 Nonrheumatic mitral (valve) stenosis
I34.81 Nonrheumatic mitral (valve) annulus calcification
I34.89 Other nonrheumatic mitral valve disorders
I34.9 Nonrheumatic mitral valve disorder, unspecified
I35.0 Nonrheumatic aortic (valve) stenosis
I35.1 Nonrheumatic aortic (valve) insufficiency
I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency
I35.8 Other nonrheumatic aortic valve disorders
I35.9 Nonrheumatic aortic valve disorder, unspecified
I36.0 Nonrheumatic tricuspid (valve) stenosis
I36.1 Nonrheumatic tricuspid (valve) insufficiency
I36.2 Nonrheumatic tricuspid (valve) stenosis with insufficiency
I36.8 Other nonrheumatic tricuspid valve disorders
I36.9 Nonrheumatic tricuspid valve disorder, unspecified
I37.0 Nonrheumatic pulmonary valve stenosis
I37.1 Nonrheumatic pulmonary valve insufficiency
I37.2 Nonrheumatic pulmonary valve stenosis with insufficiency
I37.8 Other nonrheumatic pulmonary valve disorders
I37.9 Nonrheumatic pulmonary valve disorder, unspecified
I38 Endocarditis, valve unspecified
I39 Endocarditis and heart valve disorders in diseases classified elsewhere
I40.0 Infective myocarditis
I40.1 Isolated myocarditis
I40.8 Other acute myocarditis
I40.9 Acute myocarditis, unspecified
I41 Myocarditis in diseases classified elsewhere
I42.0 Dilated cardiomyopathy
I42.1 Obstructive hypertrophic cardiomyopathy
I42.2 Other hypertrophic cardiomyopathy
I42.3 Endomyocardial (eosinophilic) disease
I42.4 Endocardial fibroelastosis
I42.5 Other restrictive cardiomyopathy
I42.6 Alcoholic cardiomyopathy
I42.7 Cardiomyopathy due to drug and external agent
I42.8 Other cardiomyopathies
I42.9 Cardiomyopathy, unspecified
I43 Cardiomyopathy in diseases classified elsewhere
I46.2 Cardiac arrest due to underlying cardiac condition
I46.8 Cardiac arrest due to other underlying condition
I46.9 Cardiac arrest, cause unspecified
I47.0 Re-entry ventricular arrhythmia
I47.20 Ventricular tachycardia, unspecified
I47.21 Torsades de pointes
I47.29 Other ventricular tachycardia
I47.9 Paroxysmal tachycardia, unspecified
I49.01 Ventricular fibrillation
I49.02 Ventricular flutter
I50.1 Left ventricular failure, unspecified
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.30 Unspecified diastolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.810 Right heart failure, unspecified
I50.811 Acute right heart failure
I50.812 Chronic right heart failure
I50.813 Acute on chronic right heart failure
I50.814 Right heart failure due to left heart failure
I50.82 Biventricular heart failure
I50.83 High output heart failure
I50.84 End stage heart failure
I50.89 Other heart failure
I50.9 Heart failure, unspecified
I51.0 Cardiac septal defect, acquired
I51.1 Rupture of chordae tendineae, not elsewhere classified
I51.2 Rupture of papillary muscle, not elsewhere classified
I51.4 Myocarditis, unspecified
I51.5 Myocardial degeneration
I51.7 Cardiomegaly
I51.89 Other ill-defined heart diseases
I97.0 Postcardiotomy syndrome
I97.110 Postprocedural cardiac insufficiency following cardiac surgery
I97.111 Postprocedural cardiac insufficiency following other surgery
I97.120 Postprocedural cardiac arrest following cardiac surgery
I97.121 Postprocedural cardiac arrest following other surgery
I97.130 Postprocedural heart failure following cardiac surgery
I97.131 Postprocedural heart failure following other surgery
I97.190 Other postprocedural cardiac functional disturbances following cardiac surgery
I97.191 Other postprocedural cardiac functional disturbances following other surgery
M32.11 Endocarditis in systemic lupus erythematosus
M32.12 Pericarditis in systemic lupus erythematosus
O90.3 Peripartum cardiomyopathy
Q21.0 Ventricular septal defect
Q21.10 Atrial septal defect, unspecified
Q21.11 Secundum atrial septal defect
Q21.12 Patent foramen ovale
Q21.13 Coronary sinus atrial septal defect
Q21.14 Superior sinus venosus atrial septal defect
Q21.15 Inferior sinus venosus atrial septal defect
Q21.16 Sinus venosus atrial septal defect, unspecified
Q21.19 Other specified atrial septal defect
Q22.5 Ebstein's anomaly
R93.1 Abnormal findings on diagnostic imaging of heart and coronary circulation
R93.89 Abnormal findings on diagnostic imaging of other specified body structures
T82.01XA Breakdown (mechanical) of heart valve prosthesis, initial encounter
T82.01XD Breakdown (mechanical) of heart valve prosthesis, subsequent encounter
T82.01XS Breakdown (mechanical) of heart valve prosthesis, sequela
T82.02XA Displacement of heart valve prosthesis, initial encounter
T82.02XD Displacement of heart valve prosthesis, subsequent encounter
T82.02XS Displacement of heart valve prosthesis, sequela
T82.03XA Leakage of heart valve prosthesis, initial encounter
T82.03XD Leakage of heart valve prosthesis, subsequent encounter
T82.03XS Leakage of heart valve prosthesis, sequela
T82.09XA Other mechanical complication of heart valve prosthesis, initial encounter
T82.09XD Other mechanical complication of heart valve prosthesis, subsequent encounter
T82.09XS Other mechanical complication of heart valve prosthesis, sequela
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z48.21 Encounter for aftercare following heart transplant
Z86.711 Personal history of pulmonary embolism
Z86.718 Personal history of other venous thrombosis and embolism
Z94.1 Heart transplant status

Group 2

(384 Codes)
Group 2 Paragraph

Left Heart Catheterization with/without Coronary and/or Bypass Angiography (CPT codes 93452, 93453, 93458, 93459, 93460, 93461)

 Group 2 Codes
Code Description
A39.50 Meningococcal carditis, unspecified
A39.51 Meningococcal endocarditis
A39.52 Meningococcal myocarditis
A52.02 Syphilitic aortitis
A52.03 Syphilitic endocarditis
A52.06 Other syphilitic heart involvement
A54.83 Gonococcal heart infection
A78 Q fever
B33.20 Viral carditis, unspecified
B33.21 Viral endocarditis
B33.22 Viral myocarditis
B37.6 Candidal endocarditis
B57.0 Acute Chagas' disease with heart involvement
B57.2 Chagas' disease (chronic) with heart involvement
C38.0 Malignant neoplasm of heart
C45.2 Mesothelioma of pericardium
D15.1 Benign neoplasm of heart
D86.0 Sarcoidosis of lung
D86.1 Sarcoidosis of lymph nodes
D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.3 Sarcoidosis of skin
D86.81 Sarcoid meningitis
D86.82 Multiple cranial nerve palsies in sarcoidosis
D86.83 Sarcoid iridocyclitis
D86.84 Sarcoid pyelonephritis
D86.85 Sarcoid myocarditis
D86.86 Sarcoid arthropathy
D86.87 Sarcoid myositis
D86.89 Sarcoidosis of other sites
D86.9 Sarcoidosis, unspecified
E51.11 Dry beriberi
E51.12 Wet beriberi
E61.9 Deficiency of nutrient element, unspecified
E63.9 Nutritional deficiency, unspecified
E64.9 Sequelae of unspecified nutritional deficiency
E74.00 Glycogen storage disease, unspecified
E74.01 von Gierke disease
E74.02 Pompe disease
E74.03 Cori disease
E74.04 McArdle disease
E74.05 Lysosome-associated membrane protein 2 [LAMP2] deficiency
E74.09 Other glycogen storage disease
E76.01 Hurler's syndrome
E76.02 Hurler-Scheie syndrome
E76.03 Scheie's syndrome
E76.1 Mucopolysaccharidosis, type II
E76.210 Morquio A mucopolysaccharidoses
E76.211 Morquio B mucopolysaccharidoses
E76.219 Morquio mucopolysaccharidoses, unspecified
E76.22 Sanfilippo mucopolysaccharidoses
E76.29 Other mucopolysaccharidoses
E76.3 Mucopolysaccharidosis, unspecified
E76.8 Other disorders of glucosaminoglycan metabolism
E76.9 Glucosaminoglycan metabolism disorder, unspecified
E84.0 Cystic fibrosis with pulmonary manifestations
E85.1 Neuropathic heredofamilial amyloidosis
E85.2 Heredofamilial amyloidosis, unspecified
E85.3 Secondary systemic amyloidosis
E85.4 Organ-limited amyloidosis
E85.81 Light chain (AL) amyloidosis
E85.82 Wild-type transthyretin-related (ATTR) amyloidosis
E85.89 Other amyloidosis
E85.9 Amyloidosis, unspecified
E88.810 Metabolic syndrome
E88.811 Insulin resistance syndrome, Type A
E88.818 Other insulin resistance
E88.819 Insulin resistance, unspecified
E88.9 Metabolic disorder, unspecified
G11.11 Friedreich ataxia
G71.01 Duchenne or Becker muscular dystrophy
G71.02 Facioscapulohumeral muscular dystrophy
G71.09 Other specified muscular dystrophies
G71.11 Myotonic muscular dystrophy
I05.0 Rheumatic mitral stenosis
I05.1 Rheumatic mitral insufficiency
I05.2 Rheumatic mitral stenosis with insufficiency
I05.8 Other rheumatic mitral valve diseases
I05.9 Rheumatic mitral valve disease, unspecified
I06.0 Rheumatic aortic stenosis
I06.1 Rheumatic aortic insufficiency
I06.2 Rheumatic aortic stenosis with insufficiency
I06.8 Other rheumatic aortic valve diseases
I06.9 Rheumatic aortic valve disease, unspecified
I07.0 Rheumatic tricuspid stenosis
I07.1 Rheumatic tricuspid insufficiency
I07.2 Rheumatic tricuspid stenosis and insufficiency
I07.8 Other rheumatic tricuspid valve diseases
I07.9 Rheumatic tricuspid valve disease, unspecified
I08.0 Rheumatic disorders of both mitral and aortic valves
I08.1 Rheumatic disorders of both mitral and tricuspid valves
I08.2 Rheumatic disorders of both aortic and tricuspid valves
I08.3 Combined rheumatic disorders of mitral, aortic and tricuspid valves
I08.8 Other rheumatic multiple valve diseases
I08.9 Rheumatic multiple valve disease, unspecified
I09.0 Rheumatic myocarditis
I09.1 Rheumatic diseases of endocardium, valve unspecified
I09.81 Rheumatic heart failure
I09.89 Other specified rheumatic heart diseases
I11.0 Hypertensive heart disease with heart failure
I20.0 Unstable angina
I20.1 Angina pectoris with documented spasm
I20.81 Angina pectoris with coronary microvascular dysfunction
I20.89 Other forms of angina pectoris
I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery
I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29 ST elevation (STEMI) myocardial infarction involving other sites
I21.3 ST elevation (STEMI) myocardial infarction of unspecified site
I21.4 Non-ST elevation (NSTEMI) myocardial infarction
I21.9 Acute myocardial infarction, unspecified
I21.A1 Myocardial infarction type 2
I21.A9 Other myocardial infarction type
I22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
I22.2 Subsequent non-ST elevation (NSTEMI) myocardial infarction
I22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sites
I23.0 Hemopericardium as current complication following acute myocardial infarction
I23.1 Atrial septal defect as current complication following acute myocardial infarction
I23.2 Ventricular septal defect as current complication following acute myocardial infarction
I23.3 Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction
I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction
I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction
I23.6 Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction
I23.7 Postinfarction angina
I23.8 Other current complications following acute myocardial infarction
I24.0 Acute coronary thrombosis not resulting in myocardial infarction
I24.1 Dressler's syndrome
I24.81 Acute coronary microvascular dysfunction
I24.89 Other forms of acute ischemic heart disease
I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.2 Old myocardial infarction
I25.3 Aneurysm of heart
I25.41 Coronary artery aneurysm
I25.42 Coronary artery dissection
I25.5 Ischemic cardiomyopathy
I25.6 Silent myocardial ischemia
I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
I25.721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
I25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
I25.799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
I25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
I25.811 Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82 Chronic total occlusion of coronary artery
I25.84 Coronary atherosclerosis due to calcified coronary lesion
I25.85 Chronic coronary microvascular dysfunction
I25.89 Other forms of chronic ischemic heart disease
I25.9 Chronic ischemic heart disease, unspecified
I31.0 Chronic adhesive pericarditis
I31.1 Chronic constrictive pericarditis
I31.2 Hemopericardium, not elsewhere classified
I31.31 Malignant pericardial effusion in diseases classified elsewhere
I31.39 Other pericardial effusion (noninflammatory)
I31.4 Cardiac tamponade
I31.8 Other specified diseases of pericardium
I31.9 Disease of pericardium, unspecified
I33.0 Acute and subacute infective endocarditis
I33.9 Acute and subacute endocarditis, unspecified
I34.0 Nonrheumatic mitral (valve) insufficiency
I34.1 Nonrheumatic mitral (valve) prolapse
I34.2 Nonrheumatic mitral (valve) stenosis
I34.81 Nonrheumatic mitral (valve) annulus calcification
I34.89 Other nonrheumatic mitral valve disorders
I34.9 Nonrheumatic mitral valve disorder, unspecified
I35.0 Nonrheumatic aortic (valve) stenosis
I35.1 Nonrheumatic aortic (valve) insufficiency
I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency
I35.8 Other nonrheumatic aortic valve disorders
I35.9 Nonrheumatic aortic valve disorder, unspecified
I38 Endocarditis, valve unspecified
I39 Endocarditis and heart valve disorders in diseases classified elsewhere
I40.0 Infective myocarditis
I40.1 Isolated myocarditis
I40.8 Other acute myocarditis
I40.9 Acute myocarditis, unspecified
I41 Myocarditis in diseases classified elsewhere
I42.0 Dilated cardiomyopathy
I42.1 Obstructive hypertrophic cardiomyopathy
I42.2 Other hypertrophic cardiomyopathy
I42.3 Endomyocardial (eosinophilic) disease
I42.4 Endocardial fibroelastosis
I42.5 Other restrictive cardiomyopathy
I42.6 Alcoholic cardiomyopathy
I42.7 Cardiomyopathy due to drug and external agent
I42.8 Other cardiomyopathies
I42.9 Cardiomyopathy, unspecified
I43 Cardiomyopathy in diseases classified elsewhere
I46.2 Cardiac arrest due to underlying cardiac condition
I46.8 Cardiac arrest due to other underlying condition
I46.9 Cardiac arrest, cause unspecified
I47.0 Re-entry ventricular arrhythmia
I47.20 Ventricular tachycardia, unspecified
I47.21 Torsades de pointes
I47.29 Other ventricular tachycardia
I47.9 Paroxysmal tachycardia, unspecified
I49.01 Ventricular fibrillation
I49.02 Ventricular flutter
I50.1 Left ventricular failure, unspecified
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.30 Unspecified diastolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.810 Right heart failure, unspecified
I50.811 Acute right heart failure
I50.812 Chronic right heart failure
I50.813 Acute on chronic right heart failure
I50.814 Right heart failure due to left heart failure
I50.82 Biventricular heart failure
I50.83 High output heart failure
I50.84 End stage heart failure
I50.89 Other heart failure
I50.9 Heart failure, unspecified
I51.0 Cardiac septal defect, acquired
I51.1 Rupture of chordae tendineae, not elsewhere classified
I51.2 Rupture of papillary muscle, not elsewhere classified
I51.3 Intracardiac thrombosis, not elsewhere classified
I51.4 Myocarditis, unspecified
I51.5 Myocardial degeneration
I51.7 Cardiomegaly
I51.81 Takotsubo syndrome
I51.89 Other ill-defined heart diseases
I97.0 Postcardiotomy syndrome
I97.110 Postprocedural cardiac insufficiency following cardiac surgery
I97.111 Postprocedural cardiac insufficiency following other surgery
I97.120 Postprocedural cardiac arrest following cardiac surgery
I97.121 Postprocedural cardiac arrest following other surgery
I97.130 Postprocedural heart failure following cardiac surgery
I97.131 Postprocedural heart failure following other surgery
I97.190 Other postprocedural cardiac functional disturbances following cardiac surgery
I97.191 Other postprocedural cardiac functional disturbances following other surgery
M05.20 Rheumatoid vasculitis with rheumatoid arthritis of unspecified site
M05.211 Rheumatoid vasculitis with rheumatoid arthritis of right shoulder
M05.212 Rheumatoid vasculitis with rheumatoid arthritis of left shoulder
M05.221 Rheumatoid vasculitis with rheumatoid arthritis of right elbow
M05.222 Rheumatoid vasculitis with rheumatoid arthritis of left elbow
M05.231 Rheumatoid vasculitis with rheumatoid arthritis of right wrist
M05.232 Rheumatoid vasculitis with rheumatoid arthritis of left wrist
M05.241 Rheumatoid vasculitis with rheumatoid arthritis of right hand
M05.242 Rheumatoid vasculitis with rheumatoid arthritis of left hand
M05.251 Rheumatoid vasculitis with rheumatoid arthritis of right hip
M05.252 Rheumatoid vasculitis with rheumatoid arthritis of left hip
M05.261 Rheumatoid vasculitis with rheumatoid arthritis of right knee
M05.262 Rheumatoid vasculitis with rheumatoid arthritis of left knee
M05.271 Rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot
M05.272 Rheumatoid vasculitis with rheumatoid arthritis of left ankle and foot
M05.29 Rheumatoid vasculitis with rheumatoid arthritis of multiple sites
M05.311 Rheumatoid heart disease with rheumatoid arthritis of right shoulder
M05.312 Rheumatoid heart disease with rheumatoid arthritis of left shoulder
M05.321 Rheumatoid heart disease with rheumatoid arthritis of right elbow
M05.322 Rheumatoid heart disease with rheumatoid arthritis of left elbow
M05.331 Rheumatoid heart disease with rheumatoid arthritis of right wrist
M05.332 Rheumatoid heart disease with rheumatoid arthritis of left wrist
M05.341 Rheumatoid heart disease with rheumatoid arthritis of right hand
M05.342 Rheumatoid heart disease with rheumatoid arthritis of left hand
M05.351 Rheumatoid heart disease with rheumatoid arthritis of right hip
M05.352 Rheumatoid heart disease with rheumatoid arthritis of left hip
M05.361 Rheumatoid heart disease with rheumatoid arthritis of right knee
M05.362 Rheumatoid heart disease with rheumatoid arthritis of left knee
M05.371 Rheumatoid heart disease with rheumatoid arthritis of right ankle and foot
M05.372 Rheumatoid heart disease with rheumatoid arthritis of left ankle and foot
M05.39 Rheumatoid heart disease with rheumatoid arthritis of multiple sites
M05.611 Rheumatoid arthritis of right shoulder with involvement of other organs and systems
M05.612 Rheumatoid arthritis of left shoulder with involvement of other organs and systems
M05.621 Rheumatoid arthritis of right elbow with involvement of other organs and systems
M05.622 Rheumatoid arthritis of left elbow with involvement of other organs and systems
M05.631 Rheumatoid arthritis of right wrist with involvement of other organs and systems
M05.632 Rheumatoid arthritis of left wrist with involvement of other organs and systems
M05.641 Rheumatoid arthritis of right hand with involvement of other organs and systems
M05.642 Rheumatoid arthritis of left hand with involvement of other organs and systems
M05.651 Rheumatoid arthritis of right hip with involvement of other organs and systems
M05.652 Rheumatoid arthritis of left hip with involvement of other organs and systems
M05.661 Rheumatoid arthritis of right knee with involvement of other organs and systems
M05.662 Rheumatoid arthritis of left knee with involvement of other organs and systems
M05.671 Rheumatoid arthritis of right ankle and foot with involvement of other organs and systems
M05.672 Rheumatoid arthritis of left ankle and foot with involvement of other organs and systems
M05.69 Rheumatoid arthritis of multiple sites with involvement of other organs and systems
M06.1 Adult-onset Still's disease
M32.0 Drug-induced systemic lupus erythematosus
M32.10 Systemic lupus erythematosus, organ or system involvement unspecified
M32.11 Endocarditis in systemic lupus erythematosus
M32.12 Pericarditis in systemic lupus erythematosus
M32.13 Lung involvement in systemic lupus erythematosus
M32.14 Glomerular disease in systemic lupus erythematosus
M32.15 Tubulo-interstitial nephropathy in systemic lupus erythematosus
M32.19 Other organ or system involvement in systemic lupus erythematosus
M32.8 Other forms of systemic lupus erythematosus
M32.9 Systemic lupus erythematosus, unspecified
O90.3 Peripartum cardiomyopathy
Q21.0 Ventricular septal defect
Q23.0 Congenital stenosis of aortic valve
Q23.1 Congenital insufficiency of aortic valve
Q23.2 Congenital mitral stenosis
Q23.3 Congenital mitral insufficiency
Q24.5 Malformation of coronary vessels
R07.2 Precordial pain
R07.82 Intercostal pain
R07.89 Other chest pain
R07.9 Chest pain, unspecified
R93.1 Abnormal findings on diagnostic imaging of heart and coronary circulation
R93.89 Abnormal findings on diagnostic imaging of other specified body structures
R94.39 Abnormal result of other cardiovascular function study
T82.01XA Breakdown (mechanical) of heart valve prosthesis, initial encounter
T82.01XD Breakdown (mechanical) of heart valve prosthesis, subsequent encounter
T82.01XS Breakdown (mechanical) of heart valve prosthesis, sequela
T82.02XA Displacement of heart valve prosthesis, initial encounter
T82.02XD Displacement of heart valve prosthesis, subsequent encounter
T82.02XS Displacement of heart valve prosthesis, sequela
T82.03XA Leakage of heart valve prosthesis, initial encounter
T82.03XD Leakage of heart valve prosthesis, subsequent encounter
T82.03XS Leakage of heart valve prosthesis, sequela
T82.09XA Other mechanical complication of heart valve prosthesis, initial encounter
T82.09XD Other mechanical complication of heart valve prosthesis, subsequent encounter
T82.09XS Other mechanical complication of heart valve prosthesis, sequela
T82.211A Breakdown (mechanical) of coronary artery bypass graft, initial encounter
T82.211D Breakdown (mechanical) of coronary artery bypass graft, subsequent encounter
T82.211S Breakdown (mechanical) of coronary artery bypass graft, sequela
T82.212A Displacement of coronary artery bypass graft, initial encounter
T82.212D Displacement of coronary artery bypass graft, subsequent encounter
T82.212S Displacement of coronary artery bypass graft, sequela
T82.213A Leakage of coronary artery bypass graft, initial encounter
T82.213D Leakage of coronary artery bypass graft, subsequent encounter
T82.213S Leakage of coronary artery bypass graft, sequela
T82.218A Other mechanical complication of coronary artery bypass graft, initial encounter
T82.218D Other mechanical complication of coronary artery bypass graft, subsequent encounter
T82.218S Other mechanical complication of coronary artery bypass graft, sequela
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z48.21 Encounter for aftercare following heart transplant
Z48.280 Encounter for aftercare following heart-lung transplant
Z94.1 Heart transplant status
Z94.3 Heart and lungs transplant status
Z95.1 Presence of aortocoronary bypass graft
Z95.3 Presence of xenogenic heart valve
Z95.4 Presence of other heart-valve replacement
Z95.5 Presence of coronary angioplasty implant and graft
Z98.61 Coronary angioplasty status

Group 3

(150 Codes)
Group 3 Paragraph

Coronary/Bypass Angiography Without Left Heart Catheterization (CPT codes 93454, 93455, 93456, 93457)

ICD-10 codes R93.1, R93.89 and R94.39 may be used for treatment planning in patients undergoing non-coronary cardiac surgical procedures (e.g., aortic or mitral valve surgery when not requiring left heart catheterization)

 Group 3 Codes
Code Description
I20.0 Unstable angina
I20.1 Angina pectoris with documented spasm
I20.81 Angina pectoris with coronary microvascular dysfunction
I20.89 Other forms of angina pectoris
I20.9 Angina pectoris, unspecified
I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery
I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29 ST elevation (STEMI) myocardial infarction involving other sites
I21.3 ST elevation (STEMI) myocardial infarction of unspecified site
I21.4 Non-ST elevation (NSTEMI) myocardial infarction
I21.9 Acute myocardial infarction, unspecified
I21.A1 Myocardial infarction type 2
I21.A9 Other myocardial infarction type
I22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
I22.2 Subsequent non-ST elevation (NSTEMI) myocardial infarction
I22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sites
I22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site
I23.0 Hemopericardium as current complication following acute myocardial infarction
I23.1 Atrial septal defect as current complication following acute myocardial infarction
I23.2 Ventricular septal defect as current complication following acute myocardial infarction
I23.3 Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction
I23.6 Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction
I23.7 Postinfarction angina
I23.8 Other current complications following acute myocardial infarction
I24.0 Acute coronary thrombosis not resulting in myocardial infarction
I24.1 Dressler's syndrome
I24.81 Acute coronary microvascular dysfunction
I24.89 Other forms of acute ischemic heart disease
I24.9 Acute ischemic heart disease, unspecified
I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.2 Old myocardial infarction
I25.41 Coronary artery aneurysm
I25.42 Coronary artery dissection
I25.5 Ischemic cardiomyopathy
I25.6 Silent myocardial ischemia
I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
I25.721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
I25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
I25.799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
I25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
I25.811 Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82 Chronic total occlusion of coronary artery
I25.84 Coronary atherosclerosis due to calcified coronary lesion
I25.85 Chronic coronary microvascular dysfunction
I25.89 Other forms of chronic ischemic heart disease
I25.9 Chronic ischemic heart disease, unspecified
I42.0 - I42.9 Dilated cardiomyopathy - Cardiomyopathy, unspecified
I51.0 Cardiac septal defect, acquired
I51.3 Intracardiac thrombosis, not elsewhere classified
I51.81 Takotsubo syndrome
I51.89 Other ill-defined heart diseases
I97.0 Postcardiotomy syndrome
I97.110 Postprocedural cardiac insufficiency following cardiac surgery
I97.111 Postprocedural cardiac insufficiency following other surgery
I97.120 Postprocedural cardiac arrest following cardiac surgery
I97.121 Postprocedural cardiac arrest following other surgery
I97.130 Postprocedural heart failure following cardiac surgery
I97.131 Postprocedural heart failure following other surgery
I97.190 Other postprocedural cardiac functional disturbances following cardiac surgery
I97.191 Other postprocedural cardiac functional disturbances following other surgery
M32.0 Drug-induced systemic lupus erythematosus
M32.10 Systemic lupus erythematosus, organ or system involvement unspecified
M32.11 Endocarditis in systemic lupus erythematosus
M32.12 Pericarditis in systemic lupus erythematosus
M32.13 Lung involvement in systemic lupus erythematosus
M32.14 Glomerular disease in systemic lupus erythematosus
M32.15 Tubulo-interstitial nephropathy in systemic lupus erythematosus
M32.19 Other organ or system involvement in systemic lupus erythematosus
M32.8 Other forms of systemic lupus erythematosus
M32.9 Systemic lupus erythematosus, unspecified
Q24.5 Malformation of coronary vessels
R07.2 Precordial pain
R07.82 Intercostal pain
R07.89 Other chest pain
R07.9 Chest pain, unspecified
R93.1 Abnormal findings on diagnostic imaging of heart and coronary circulation
R93.89 Abnormal findings on diagnostic imaging of other specified body structures
R94.39 Abnormal result of other cardiovascular function study
T82.211A Breakdown (mechanical) of coronary artery bypass graft, initial encounter
T82.211D Breakdown (mechanical) of coronary artery bypass graft, subsequent encounter
T82.211S Breakdown (mechanical) of coronary artery bypass graft, sequela
T82.212A Displacement of coronary artery bypass graft, initial encounter
T82.212D Displacement of coronary artery bypass graft, subsequent encounter
T82.212S Displacement of coronary artery bypass graft, sequela
T82.213A Leakage of coronary artery bypass graft, initial encounter
T82.213D Leakage of coronary artery bypass graft, subsequent encounter
T82.213S Leakage of coronary artery bypass graft, sequela
T82.218A Other mechanical complication of coronary artery bypass graft, initial encounter
T82.218D Other mechanical complication of coronary artery bypass graft, subsequent encounter
T82.218S Other mechanical complication of coronary artery bypass graft, sequela
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z48.21 Encounter for aftercare following heart transplant
Z94.1 Heart transplant status
Z95.1 Presence of aortocoronary bypass graft
Z95.5 Presence of coronary angioplasty implant and graft
Z98.61 Coronary angioplasty status

Group 4

(78 Codes)
Group 4 Paragraph

Congenital Heart Disease (CPT codes 93593, 93594, 93595, 93596, 93597, 93598)

 Group 4 Codes
Code Description
Q20.0 Common arterial trunk
Q20.1 Double outlet right ventricle
Q20.2 Double outlet left ventricle
Q20.3 Discordant ventriculoarterial connection
Q20.4 Double inlet ventricle
Q20.5 Discordant atrioventricular connection
Q20.6 Isomerism of atrial appendages
Q20.8 Other congenital malformations of cardiac chambers and connections
Q20.9 Congenital malformation of cardiac chambers and connections, unspecified
Q21.0 Ventricular septal defect
Q21.10 Atrial septal defect, unspecified
Q21.11 Secundum atrial septal defect
Q21.12 Patent foramen ovale
Q21.13 Coronary sinus atrial septal defect
Q21.14 Superior sinus venosus atrial septal defect
Q21.15 Inferior sinus venosus atrial septal defect
Q21.16 Sinus venosus atrial septal defect, unspecified
Q21.19 Other specified atrial septal defect
Q21.20 Atrioventricular septal defect, unspecified as to partial or complete
Q21.21 Partial atrioventricular septal defect
Q21.22 Transitional atrioventricular septal defect
Q21.23 Complete atrioventricular septal defect
Q21.3 Tetralogy of Fallot
Q21.4 Aortopulmonary septal defect
Q21.8 Other congenital malformations of cardiac septa
Q21.9 Congenital malformation of cardiac septum, unspecified
Q22.0 Pulmonary valve atresia
Q22.1 Congenital pulmonary valve stenosis
Q22.2 Congenital pulmonary valve insufficiency
Q22.3 Other congenital malformations of pulmonary valve
Q22.4 Congenital tricuspid stenosis
Q22.5 Ebstein's anomaly
Q22.6 Hypoplastic right heart syndrome
Q22.8 Other congenital malformations of tricuspid valve
Q22.9 Congenital malformation of tricuspid valve, unspecified
Q23.0 Congenital stenosis of aortic valve
Q23.1 Congenital insufficiency of aortic valve
Q23.2 Congenital mitral stenosis
Q23.3 Congenital mitral insufficiency
Q23.4 Hypoplastic left heart syndrome
Q23.81 Bicuspid aortic valve
Q23.82 Congenital mitral valve cleft leaflet
Q23.88 Other congenital malformations of aortic and mitral valves
Q23.9 Congenital malformation of aortic and mitral valves, unspecified
Q24.2 Cor triatriatum
Q24.3 Pulmonary infundibular stenosis
Q24.4 Congenital subaortic stenosis
Q24.5 Malformation of coronary vessels
Q24.8 Other specified congenital malformations of heart
Q24.9 Congenital malformation of heart, unspecified
Q25.0 Patent ductus arteriosus
Q25.1 Coarctation of aorta
Q25.21 Interruption of aortic arch
Q25.29 Other atresia of aorta
Q25.3 Supravalvular aortic stenosis
Q25.40 - Q25.49 Congenital malformation of aorta unspecified - Other congenital malformations of aorta
Q25.5 Atresia of pulmonary artery
Q25.6 Stenosis of pulmonary artery
Q25.71 Coarctation of pulmonary artery
Q25.72 Congenital pulmonary arteriovenous malformation
Q25.79 Other congenital malformations of pulmonary artery
Q25.8 Other congenital malformations of other great arteries
Q25.9 Congenital malformation of great arteries, unspecified
Q26.2 Total anomalous pulmonary venous connection
Q26.3 Partial anomalous pulmonary venous connection
Q26.4 Anomalous pulmonary venous connection, unspecified
Q26.9 Congenital malformation of great vein, unspecified
R93.1 Abnormal findings on diagnostic imaging of heart and coronary circulation
R93.89 Abnormal findings on diagnostic imaging of other specified body structures

Group 5

(26 Codes)
Group 5 Paragraph

Endomyocardial Biopsy (CPT Code 93505)

 Group 5 Codes
Code Description
A18.84 Tuberculosis of heart
I40.0 Infective myocarditis
I40.1 Isolated myocarditis
I40.8 Other acute myocarditis
I41 Myocarditis in diseases classified elsewhere
I42.0 Dilated cardiomyopathy
I42.3 Endomyocardial (eosinophilic) disease
I42.4 Endocardial fibroelastosis
I42.5 Other restrictive cardiomyopathy
I42.8 Other cardiomyopathies
I42.9 Cardiomyopathy, unspecified
I43 Cardiomyopathy in diseases classified elsewhere
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z48.21 Encounter for aftercare following heart transplant
Z94.1 Heart transplant status

Group 6

(195 Codes)
Group 6 Paragraph

Extra-Cardiac Angiography (CPT Codes 75625, 75630, 75705, 75710, 75716 and 36140, 36200, 36215-36218, 36245-36248, 36251-36254 Performed During the Same Encounter as Cardiac Catheterization

The ICD-10 code list below applies to these procedures only when related to provisions in this LCD.

 Group 6 Codes
Code Description
G45.8 Other transient cerebral ischemic attacks and related syndromes
G45.9 Transient cerebral ischemic attack, unspecified
I10 Essential (primary) hypertension
I11.0 Hypertensive heart disease with heart failure
I11.9 Hypertensive heart disease without heart failure
I12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
I12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.10 Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.11 Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I15.0 Renovascular hypertension
I15.1 Hypertension secondary to other renal disorders
I16.0 Hypertensive urgency
I16.1 Hypertensive emergency
I16.9 Hypertensive crisis, unspecified
I63.031 Cerebral infarction due to thrombosis of right carotid artery
I63.032 Cerebral infarction due to thrombosis of left carotid artery
I63.039 Cerebral infarction due to thrombosis of unspecified carotid artery
I63.131 Cerebral infarction due to embolism of right carotid artery
I63.132 Cerebral infarction due to embolism of left carotid artery
I63.139 Cerebral infarction due to embolism of unspecified carotid artery
I63.231 Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232 Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I65.21 Occlusion and stenosis of right carotid artery
I65.22 Occlusion and stenosis of left carotid artery
I65.23 Occlusion and stenosis of bilateral carotid arteries
I65.8 Occlusion and stenosis of other precerebral arteries
I67.0 Dissection of cerebral arteries, nonruptured
I67.841 Reversible cerebrovascular vasoconstriction syndrome
I67.848 Other cerebrovascular vasospasm and vasoconstriction
I67.850 Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
I67.858 Other hereditary cerebrovascular disease
I70.0 Atherosclerosis of aorta
I70.1 Atherosclerosis of renal artery
I70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
I70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg
I70.213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
I70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity
I70.221 Atherosclerosis of native arteries of extremities with rest pain, right leg
I70.222 Atherosclerosis of native arteries of extremities with rest pain, left leg
I70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
I70.228 Atherosclerosis of native arteries of extremities with rest pain, other extremity
I70.231 Atherosclerosis of native arteries of right leg with ulceration of thigh
I70.232 Atherosclerosis of native arteries of right leg with ulceration of calf
I70.233 Atherosclerosis of native arteries of right leg with ulceration of ankle
I70.234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot
I70.235 Atherosclerosis of native arteries of right leg with ulceration of other part of foot
I70.238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
I70.239 Atherosclerosis of native arteries of right leg with ulceration of unspecified site
I70.241 Atherosclerosis of native arteries of left leg with ulceration of thigh
I70.242 Atherosclerosis of native arteries of left leg with ulceration of calf
I70.243 Atherosclerosis of native arteries of left leg with ulceration of ankle
I70.244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot
I70.245 Atherosclerosis of native arteries of left leg with ulceration of other part of foot
I70.248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg
I70.249 Atherosclerosis of native arteries of left leg with ulceration of unspecified site
I70.25 Atherosclerosis of native arteries of other extremities with ulceration
I70.261 Atherosclerosis of native arteries of extremities with gangrene, right leg
I70.262 Atherosclerosis of native arteries of extremities with gangrene, left leg
I70.263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legs
I70.268 Atherosclerosis of native arteries of extremities with gangrene, other extremity
I70.401 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg
I70.402 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, left leg
I70.403 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral legs
I70.408 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, other extremity
I70.411 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, right leg
I70.412 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, left leg
I70.413 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs
I70.418 Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, other extremity
I70.421 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, right leg
I70.422 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, left leg
I70.423 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, bilateral legs
I70.428 Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, other extremity
I70.431 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of thigh
I70.432 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of calf
I70.433 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of ankle
I70.434 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of heel and midfoot
I70.435 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot
I70.438 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of lower leg
I70.439 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of unspecified site
I70.441 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of thigh
I70.442 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of calf
I70.443 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of ankle
I70.444 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of heel and midfoot
I70.445 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of foot
I70.448 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of other part of lower leg
I70.449 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration of unspecified site
I70.45 Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration
I70.461 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg
I70.462 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, left leg
I70.463 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, bilateral legs
I70.491 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg
I70.492 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, left leg
I70.493 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, bilateral legs
I70.498 Other atherosclerosis of autologous vein bypass graft(s) of the extremities, other extremity
I70.501 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, right leg
I70.502 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, left leg
I70.503 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, bilateral legs
I70.508 Unspecified atherosclerosis of nonautologous biological bypass graft(s) of the extremities, other extremity
I70.511 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, right leg
I70.512 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, left leg
I70.513 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, bilateral legs
I70.518 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, other extremity
I70.521 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, right leg
I70.522 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, left leg
I70.523 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, bilateral legs
I70.528 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, other extremity
I70.531 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of thigh
I70.532 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of calf
I70.533 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of ankle
I70.534 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of heel and midfoot
I70.535 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of foot
I70.538 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg
I70.539 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of unspecified site
I70.541 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of thigh
I70.542 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf
I70.543 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of ankle
I70.544 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of heel and midfoot
I70.545 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of foot
I70.548 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of other part of lower leg
I70.549 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of unspecified site
I70.55 Atherosclerosis of nonautologous biological bypass graft(s) of other extremity with ulceration
I70.561 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, right leg
I70.562 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, left leg
I70.563 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene, bilateral legs
I70.591 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, right leg
I70.592 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, left leg
I70.593 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, bilateral legs
I70.598 Other atherosclerosis of nonautologous biological bypass graft(s) of the extremities, other extremity
I71.00 Dissection of unspecified site of aorta
I71.010 Dissection of ascending aorta
I71.011 Dissection of aortic arch
I71.012 Dissection of descending thoracic aorta
I71.019 Dissection of thoracic aorta, unspecified
I71.02 Dissection of abdominal aorta
I71.03 Dissection of thoracoabdominal aorta
I71.11 Aneurysm of the ascending aorta, ruptured
I71.12 Aneurysm of the aortic arch, ruptured
I71.13 Aneurysm of the descending thoracic aorta, ruptured
I71.21 Aneurysm of the ascending aorta, without rupture
I71.22 Aneurysm of the aortic arch, without rupture
I71.23 Aneurysm of the descending thoracic aorta, without rupture
I71.31 Pararenal abdominal aortic aneurysm, ruptured
I71.32 Juxtarenal abdominal aortic aneurysm, ruptured
I71.33 Infrarenal abdominal aortic aneurysm, ruptured
I71.41 Pararenal abdominal aortic aneurysm, without rupture
I71.42 Juxtarenal abdominal aortic aneurysm, without rupture
I71.43 Infrarenal abdominal aortic aneurysm, without rupture
I71.51 Supraceliac aneurysm of the thoracoabdominal aorta, ruptured
I71.52 Paravisceral aneurysm of the thoracoabdominal aorta, ruptured
I71.61 Supraceliac aneurysm of the thoracoabdominal aorta, without rupture
I71.62 Paravisceral aneurysm of the thoracoabdominal aorta, without rupture
I71.8 Aortic aneurysm of unspecified site, ruptured
I71.9 Aortic aneurysm of unspecified site, without rupture
I72.0 Aneurysm of carotid artery
I72.1 Aneurysm of artery of upper extremity
I72.2 Aneurysm of renal artery
I72.3 Aneurysm of iliac artery
I72.4 Aneurysm of artery of lower extremity
I72.5 Aneurysm of other precerebral arteries
I72.6 Aneurysm of vertebral artery
I72.8 Aneurysm of other specified arteries
I73.1 Thromboangiitis obliterans [Buerger's disease]
I74.01 Saddle embolus of abdominal aorta
I74.09 Other arterial embolism and thrombosis of abdominal aorta
I74.10 Embolism and thrombosis of unspecified parts of aorta
I74.11 Embolism and thrombosis of thoracic aorta
I74.19 Embolism and thrombosis of other parts of aorta
I74.2 Embolism and thrombosis of arteries of the upper extremities
I74.3 Embolism and thrombosis of arteries of the lower extremities
I74.5 Embolism and thrombosis of iliac artery
I74.8 Embolism and thrombosis of other arteries
I75.011 Atheroembolism of right upper extremity
I75.012 Atheroembolism of left upper extremity
I75.013 Atheroembolism of bilateral upper extremities
I75.021 Atheroembolism of right lower extremity
I75.022 Atheroembolism of left lower extremity
I75.023 Atheroembolism of bilateral lower extremities
I75.81 Atheroembolism of kidney
I75.89 Atheroembolism of other site
I77.3 Arterial fibromuscular dysplasia
I77.70 Dissection of unspecified artery
I77.71 Dissection of carotid artery
I77.72 Dissection of iliac artery
I77.73 Dissection of renal artery
I77.74 Dissection of vertebral artery
I77.75 Dissection of other precerebral arteries
I77.76 Dissection of artery of upper extremity
I77.77 Dissection of artery of lower extremity
I77.79 Dissection of other specified artery
I79.0 Aneurysm of aorta in diseases classified elsewhere
M31.4 Aortic arch syndrome [Takayasu]
N26.2 Page kidney
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ICD-10-CM Codes that DO NOT Support Medical Necessity

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 Group 1 Codes

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ICD-10-PCS Codes

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 Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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 Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2024 R10

Due to the annual ICD-10 code updates, ICD-10 code Q23.8 has been deleted from Group 4 in the ICD-10-CM Codes that Support Medical Necessity section and the following codes have been added: Q23.81, Q23.82 and Q23.88.
10/01/2023 R9

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

  • ICD-10 code E88.81 has been deleted and ICD-10 codes E88.810, E88.811, E88.818, and E88.819 were added to group 2.
  • ICD-10 codes 120.8 has been deleted and codes I20.81 and I20.89 were added to groups 2 and 3.
  • ICD-10 codes I24.8 has been deleted and codes I24.81 and I24.89 were added to groups 2 and 3.
  • I71.51, I71.52, I71.61 and I71.62 descriptors were changed in Group 6.
  • ICD-10 code I25.85 was added to groups 2 and 3.
  • ICD-10 code E74.05 was added to groups 1 and 2.

A typographical error was corrected in this statement:

Use CPT code 93541 or other appropriate right heart catheterization code (93453, 93456, 93457, 93460 or 93461) when right heart catheterization is done in a cardiac catheterization laboratory or in an interventional radiology laboratory and the procedure is done as part of a formal cardiac catheterization study.

I71.51 descriptor was changed in Group 6
I71.52 descriptor was changed in Group 6
I71.61 descriptor was changed in Group 6
I71.62 descriptor was changed in Group 6
10/01/2022 R8

Due to the annual ICD-10 updates for 2023, the following coding has been revised:

ICD-10 code I31.3 is deleted and replaced by codes I31.31 and I31.39 in groups 1 and 2;

ICD-10 code I34.8 is deleted and replaced by codes I34.81 and I34.89 in groups 1 and 2;

ICD-10 code I47.2 is deleted and replaced by codes I47.20, I47.21 and I47 29 in groups 1 and 2;

ICD-10 code I71.01 is deleted and replaced by codes I71.010, I71.011, I71.012, I71.019 in group 6;

ICD-10 code I71.1 is deleted and replaced by codes I71.11, I71.12, and I71.13 in group 6;

ICD-10 code I71.2 is deleted and replaced by codes I71.21, I71.22, and I71.23 in group 6;

ICD-10 code I71.3 is deleted and replaced by codes I71.31, I71.32, and I71.33 in group 6;

ICD-10 code I71.4 is deleted and replaced by codes I71.41, I71.42, and I71.43 in group 6;

ICD-10 code I71.5 is deleted and replaced by codes I71.51, and I71.52 in group 6;

ICD-10 code I71.6 is deleted and replaced by codes I71.61, and I71.62 in group 6;

ICD-10 code Q21.1 is deleted and replaced by codes Q21.10, Q21.11, Q21.12, Q21.13, Q21.14, Q21.15, Q21.16 and Q21.19 in groups 1 and 4.

ICD-10 code Q21.2 is deleted and replaced by codes Q21.20, Q21.21, Q21.22 and Q21.23 in group 4.
01/01/2022 R7

Based on the annual CPT/HCPCS updates for 2022, CPT codes 93530, 93531, 93532 and 93533 have been deleted and replaced by codes 93593, 93594, 93595, 93596, 93597 and 93598 for evaluation of congenital heart defects. CPT codes 93561 and 93562 have been deleted and replaced by code 93598 for cardiac output measurement.
10/01/2020 R6

Based on the annual ICD-10 updates for 2021, ICD-10 code G11.1 was deleted and is replaced by G11.11 in Groups 1 and 2 covered diagnoses. In addition, to clarify coding, the ICD-10 section has been revised to remove the requirement for multiple ICD-10 groups for specified CPT codes, and Group 3 has been revised to remove CPT codes 93458, 93459, 93460 and 93461.
10/01/2019 R5

The article has been revised to add ICD-10 codes I42.0-I42.9 to Group 3 covered diagnoses, effective for dates of service from 10/1/2019.
10/01/2019 R4

This article was converted to the new Billing and Coding Article type.

Bill types and Revenue codes have been removed from this article. Guidance on these codes is available in the Bill type and Revenue code sections.

ICD-10 codes I70.238 and I70.248 have been revised.
08/01/2019 R3

CPT code 93563 was removed from Group 4 ICD-10 code section, as this is an add-on code.
08/01/2019 R2

The title of the article has been revised to add “Billing and Coding”. The article has been revised to add ICD-10-CM coding sections, Documentation Requirements and Utilization Guidelines.
10/01/2015 R1 Place of service guidelines under Part B were removed from the article.
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