American Heart Month: February Isn’t Just for Valentine’s Day
February is a month filled with romance, but it’s also a month aimed at raising awareness of heart diseases and illness. Throughout this month, with heart-shaped decorations all around us, it’s important to keep your own heart and heart health in mind.
Heart Disease Facts and Statistics
According to the CDC Fact Sheet about Heart Disease, about 1 in 4 deaths in the U.S. is related to heart disease. Health problems related to heart disease are also increasingly common. It is estimated that every 40 seconds, someone in this country experiences a heart attack. That equals to just over 2,000 heart attacks every day, and almost 790,000 every year!
Overall, heart disease is the leading cause of death for both men and women in the United States, a statistic that remains true across most demographic groups in the country. In the few groups where heart disease is not the top cause of death, it comes in second, beaten only by cancer. There are a number of risk factors for developing heart disease, including:
· High blood pressure
· High LDL cholesterol
· Smoking
· Diabetes
· Overweightness or obesity
· Poor diet
· Physical inactivity
· Excessive alcohol use
Of these risk factors, high blood pressure, high cholesterol, and smoking are often considered the top three risk factors. For example, almost half of Americans have high blood pressure, whether they are aware of it or not.
Coding Different Types of Heart Disease
Because the term “heart disease” encompasses a number of health problems related to the cardiovascular system, there is also a huge variety of ways that heart diseases and conditions are coded in medical records and billing. Some of the codes you may see related to heart disease encompass:
· Coronary artery disease (CAD)
Also known as Coronary Atherosclerosis, this is one of the most common types of heart disease in the U.S. It is caused by a buildup of plaque in the arteries, which narrows the inside of the arteries over time, blocking the flow of blood to the heart. This plaque is an unstable collection of lipids (cholesterol and fatty acids) and white blood cells that build up along the walls of the artery. CAD typically results in chest pain or heart damage, and for some people, the first sign that they have this disease is a heart attack. To code an unspecified type of CAD, you might use:
o In ICD-10: I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
o In ICD-11-MMS: BA80.Z Coronary atherosclerosis, unspecified site
Heart attacks, or acute myocardia infarction, occur when part of the heart muscle doesn’t get enough blood flow, causing heart cells to begin dying. It is most commonly due to a blockage in a coronary artery, sometimes due to plaque buildup. Heart attacks can be particularly dangerous because an estimated 1 in 5 heart attacks is silent, which means that damage is done to the heart, but the person is not aware that they have actually suffered a heart attack. In medical records, you might code an unspecified heart attack with:
o In ICD-10: I21.9 Acute myocardial infarction, unspecified
o In ICD-11-MMS: BA41.2 Acute myocardial infarction, without specification of ST elevation
· Hypertensive Heart Disease
Uncontrolled and prolonged hypertension, or high blood pressure, can lead to a variety of changes in the myocardial structure, coronary vasculature, and conduction system of the heart muscle. “Hypertensive heart disease” is a term applied to many heart diseases, such as left ventricular hypertrophy, coronary artery disease, cardiac arrhythmias, and congestive heart failure. These heart diseases are grouped together because they are all caused by direct or indirect effects of hypertension, and might be coded using:
o In ICD-10: I11.9 Hypertensive heart disease without heart failure
o In ICD-11-MMS: BA01 Hypertensive heart disease
· Stroke
In the past, strokes have often been grouped together with heart diseases because of their relationship to blood flow. Your brain uses approximately 20% of the oxygen you breathe, and relies on arteries to deliver oxygen-rich blood to it. A stroke happens when something blocks blood flow to part of the brain or a blood vessel in the brain bursts, causing brain damage, disability, or sometimes death. In ICD-10 codes, strokes are categorized with heart disorders, but in ICD-11, they will be categorized with Cerebrovascular diseases:
o In ICD-10: I63.9 Cerebral infarction, unspecified
o In ICD-11-MMS: 8B20 Stroke not known if ischaemic or haemorrhagic (this stroke subtype is determined using neuroimaging or similar techniques)
Keep your coding skills sharp with ICD-10 Training!
Resources and Programs
There are a number of healthcare programs that provide resources for preventing, detecting, and managing heart disease. Some of the most prominent are:
· Million Hearts is a CDC program that provides tools, protocols, and research related to heart disease, alongside information and prevention techniques, for healthcare professionals.
· WISEWOMAN, which stands for Well-Integrated Screening and Evaluations for WOMen Across the Nation, is another CDC program aimed at heart health. This program was created to help women understand and reduce their risk for heart disease and stroke by providing services and education. It is geared largely towards low-income, uninsured, and underinsured women of middle age and older.
· The American Heart Association also provides a number of resources to both help you keep your own heart healthy, and also provide care and support for someone else with heart disease.