ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesI47.21

I47.21

Billable

Torsades de pointes

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

Code Description

ICD-10 I47.21 is a billable code used to indicate a diagnosis of torsades de pointes.

Key Diagnostic Point:

Torsades de pointes (TdP) is a specific form of polymorphic ventricular tachycardia characterized by a distinctive pattern of QRS complexes that appear to twist around the baseline on an electrocardiogram (ECG). This arrhythmia is often associated with a prolonged QT interval, which can be congenital or acquired due to various factors such as medications, electrolyte imbalances, or underlying heart conditions. Clinically, TdP can present with symptoms ranging from palpitations and dizziness to syncope or sudden cardiac arrest. The anatomy involved primarily includes the ventricles of the heart, where abnormal electrical activity disrupts normal cardiac rhythm. Disease progression can lead to more severe arrhythmias or even ventricular fibrillation if not promptly treated. Diagnostic considerations include a thorough patient history, ECG analysis, and possibly electrophysiological studies to determine the underlying cause of the prolonged QT interval. Management may involve addressing the precipitating factors, administering magnesium sulfate, or using antiarrhythmic medications, and in some cases, implantable cardioverter-defibrillators (ICDs) may be indicated.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Emergency 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

Torsades de pointes has significant clinical implications, particularly in populations with underlying cardiovascular diseases. Its occurrence can lead to serious outcomes, including sudden cardiac death, making early recognition and management critical. Epidemiologically, TdP is more prevalent in patients with congenital long QT syndrome and those on certain medications, highlighting the need for awareness in both clinical practice and public health initiatives aimed at reducing arrhythmia-related morbidity and mortality.

ICD-9 vs ICD-10

Torsades de pointes has significant clinical implications, particularly in populations with underlying cardiovascular diseases. Its occurrence can lead to serious outcomes, including sudden cardiac death, making early recognition and management critical. Epidemiologically, TdP is more prevalent in patients with congenital long QT syndrome and those on certain medications, highlighting the need for awareness in both clinical practice and public health initiatives aimed at reducing arrhythmia-related morbidity and mortality.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of the arrhythmia and its underlying causes. Common denials may arise from insufficient documentation of the patient's symptoms or the lack of a clear diagnosis. Best practices include ensuring that all relevant clinical information is included in the medical record and that the coding accurately reflects the complexity of the condition.

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 I47.21?

I47.21 specifically covers Torsades de pointes, which may arise from congenital long QT syndrome, drug-induced QT prolongation, or electrolyte disturbances such as hypokalemia or hypomagnesemia.

When should I47.21 be used instead of related codes?

I47.21 should be used when the clinical presentation aligns with Torsades de pointes, particularly when there is evidence of a prolonged QT interval and the characteristic ECG findings. Related codes may apply if the arrhythmia is stable or if other types of ventricular tachycardia are present.

What documentation supports I47.21?

Documentation should include a detailed ECG report showing the characteristic twisting pattern, clinical notes on the patient's symptoms, history of QT prolongation, and any relevant lab results indicating electrolyte levels.