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v1.0.0
ICD-10 Guide
ICD-10 CodesI24.1

I24.1

Billable

Dressler's syndrome

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

Code Description

ICD-10 I24.1 is a billable code used to indicate a diagnosis of dressler's syndrome.

Key Diagnostic Point:

Dressler's syndrome, also known as post-myocardial infarction syndrome, is an autoimmune response that occurs after myocardial infarction (heart attack) or cardiac surgery. It is characterized by the development of pericarditis, which is inflammation of the pericardium, the fibrous sac surrounding the heart. Clinically, patients may present with chest pain, fever, and a pericardial friction rub upon auscultation. The pathophysiology involves the immune system's reaction to myocardial antigens released during tissue damage, leading to inflammation. The disease progression typically occurs weeks to months after the initial cardiac event, although it can manifest as early as a few days post-infarction. Diagnostic considerations include a thorough clinical evaluation, imaging studies such as echocardiography to assess pericardial effusion, and laboratory tests to rule out other causes of chest pain. Treatment often involves anti-inflammatory medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, to manage symptoms and reduce inflammation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other causes of chest pain and pericarditis.
  • Treatment complexity: Involves managing inflammation and potential complications.
  • Documentation requirements: Detailed clinical notes and follow-up assessments are necessary.
  • Coding specificity: Requires accurate coding to reflect the condition and its sequelae.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of pericarditis.
  • Documentation gaps: Insufficient clinical details regarding the autoimmune response.
  • Billing challenges: Potential denials if the condition is not well-documented or justified.

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

Dressler's syndrome has significant clinical implications, as it can lead to complications such as cardiac tamponade if not properly managed. The condition affects a subset of patients post-myocardial infarction, contributing to healthcare utilization patterns, including increased hospital visits and potential readmissions. Understanding and addressing Dressler's syndrome is crucial for improving quality measures in cardiac care and enhancing patient outcomes.

ICD-9 vs ICD-10

Dressler's syndrome has significant clinical implications, as it can lead to complications such as cardiac tamponade if not properly managed. The condition affects a subset of patients post-myocardial infarction, contributing to healthcare utilization patterns, including increased hospital visits and potential readmissions. Understanding and addressing Dressler's syndrome is crucial for improving quality measures in cardiac care and enhancing patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the condition is clearly linked to prior myocardial infarction or cardiac surgery. Common denials may arise from insufficient documentation of the autoimmune nature of the syndrome or failure to provide evidence of related symptoms. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and following up on any claims denials with appropriate documentation.

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 I24.1?

I24.1 specifically covers Dressler's syndrome, which is an autoimmune pericarditis occurring after myocardial infarction or cardiac surgery. It is characterized by symptoms such as chest pain, fever, and pericardial effusion.

When should I24.1 be used instead of related codes?

I24.1 should be used when the patient presents with pericarditis that is specifically attributed to an autoimmune response following a myocardial infarction or cardiac surgery, differentiating it from other causes of pericarditis.

What documentation supports I24.1?

Documentation should include a clear history of myocardial infarction or cardiac surgery, clinical symptoms consistent with Dressler's syndrome, results from imaging studies showing pericardial effusion, and any laboratory findings that support the diagnosis.