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v1.0.0
ICD-10 Guide
DiagnosesHypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy

ICD-10 Coding for Hypertrophic Cardiomyopathy(I42.1, I42.2)

PRIMARY SPECIALTYCardiology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Hypertrophic Cardiomyopathy?
Essential facts and insights about Hypertrophic Cardiomyopathy

Key Clinical Considerations:

  • Dyspnea on exertion
  • Chest pain
  • Palpitations
  • Syncope
  • Family history of sudden cardiac death
  • Key diagnostic tests include echocardiogram showing left ventricular hypertrophy, ECG abnormalities, and genetic testing for familial cases.
  • Physical exam may reveal a systolic ejection murmur, abnormal heart sounds, and signs of heart failure.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document patient history including symptoms, family history, and risk factors.
  • Use specific coding terminology such as 'hypertrophic cardiomyopathy' and 'left ventricular hypertrophy'.
  • Examples include detailed descriptions of echocardiogram findings and any relevant genetic testing results.

Coding Guidelines

Usage Guidelines & Examples

  • Follow usage guidelines for coding hypertrophic cardiomyopathy to avoid miscoding.
  • Common errors include misclassifying the type of cardiomyopathy or omitting family history.

Code Exclusions

Important Exclusions

  • Excluded conditions include other types of cardiomyopathy such as dilated or restrictive cardiomyopathy.
  • Alternative codes may include I42.0 (Dilated cardiomyopathy) or I42.9 (Cardiomyopathy, unspecified).

Related ICD-10 Codes

Primary Codes
I42.1
Hypertrophic cardiomyopathy
Ancillary Codes
I48.91
Z84.89
Differential Codes
I42.2
I42.1

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Patient populations include individuals with a family history of cardiomyopathy and athletes.
  • Clinical settings include cardiology clinics, hospitals, and genetic counseling centers.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document clinical symptoms, diagnostic test results, and family history.

What are the billing considerations?

Ensure accurate coding to reflect the severity and type of hypertrophic cardiomyopathy for appropriate reimbursement.