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ICD-10 Guide
ICD-10 CodesI23.6

I23.6

Billable

Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I23.6 is a billable code used to indicate a diagnosis of thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction.

Key Diagnostic Point:

I23.6 refers to thrombosis of the atrium, auricular appendage, and ventricle as a current complication following an acute myocardial infarction (AMI). This condition arises when a blood clot forms in the heart's chambers, particularly after the heart muscle has been damaged due to an AMI. Clinically, patients may present with symptoms such as chest pain, palpitations, or shortness of breath, which may indicate compromised cardiac function. The anatomy involved includes the left and right atria, the auricular appendages, and the ventricles, where thrombus formation can lead to serious complications like embolism. Disease progression can result in further ischemic events or heart failure if not managed appropriately. Diagnostic considerations include echocardiography, which can visualize thrombi, and cardiac biomarkers to assess myocardial injury. Timely identification and management are crucial to prevent adverse outcomes, including stroke or further myocardial damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm thrombosis.
  • Treatment complexity: Management may involve anticoagulation therapy and monitoring for complications.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other myocardial infarction complications.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of thrombosis or failure to document the acute myocardial infarction.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results to support the diagnosis.
  • Billing challenges: Potential denials if documentation does not clearly establish the connection to acute myocardial infarction.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I23.6 lies in its potential to lead to serious complications, including stroke and heart failure, which can significantly impact patient outcomes. Understanding the epidemiology of thrombosis post-myocardial infarction helps in identifying at-risk populations and implementing preventive measures. Quality measures may include monitoring for thrombus formation in post-AMI patients, influencing healthcare utilization patterns and resource allocation in cardiovascular care.

ICD-9 vs ICD-10

The clinical significance of I23.6 lies in its potential to lead to serious complications, including stroke and heart failure, which can significantly impact patient outcomes. Understanding the epidemiology of thrombosis post-myocardial infarction helps in identifying at-risk populations and implementing preventive measures. Quality measures may include monitoring for thrombus formation in post-AMI patients, influencing healthcare utilization patterns and resource allocation in cardiovascular care.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the services provided, such as imaging and monitoring. Common denials may occur if the documentation does not adequately support the diagnosis or if there are discrepancies in the coding. Best practices include thorough documentation of clinical findings, treatment plans, and follow-up care to substantiate the medical necessity of services rendered.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I23.6?

I23.6 covers thrombosis occurring in the atrium, auricular appendage, and ventricle as a direct complication of an acute myocardial infarction. It is important to document the presence of thrombus and its location within the heart chambers.

When should I23.6 be used instead of related codes?

I23.6 should be used when there is clear evidence of thrombosis in the specified heart chambers following an acute myocardial infarction. It is distinct from codes that describe other complications or types of myocardial infarction.

What documentation supports I23.6?

Documentation should include clinical findings, imaging studies (such as echocardiograms), and any laboratory results that indicate myocardial infarction and subsequent thrombus formation. Detailed notes on the patient's symptoms and treatment plan are also essential.