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v1.0.0
ICD-10 Guide
DiagnosesPlavix

Plavix

ICD-10 Coding for Plavix Use and Adverse Effects(Z79.02, T45.525A, D69.6)

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

Diagnosis Overview

What is Plavix?
Essential facts and insights about Plavix Use and Adverse Effects

Key Clinical Considerations:

  • Increased risk of thrombotic events, such as myocardial infarction or stroke
  • Platelet aggregation tests showing high reactivity
  • Signs of cardiovascular disease during physical examination, such as elevated blood pressure or abnormal heart sounds

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of cardiovascular events or risk factors
  • Indication for Plavix therapy, including previous antiplatelet therapy failures
  • Detailed description of any adverse reactions or side effects

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for antiplatelet therapy coding to avoid miscoding.
  • Common errors include using outdated codes or failing to document the indication for therapy.

Code Exclusions

Important Exclusions

  • Patients with active bleeding disorders or hypersensitivity to clopidogrel
  • Alternative codes for other antiplatelet medications like aspirin or ticagrelor

Related ICD-10 Codes

Primary Codes
I25.10
Atherosclerotic heart disease of native coronary artery without angina pectoris
I63.9
Cerebral infarction, unspecified
Ancillary Codes
K92.2
T45.525
A to specify the bleeding site.
Differential Codes
Z79.01
Z79.01
for anticoagulants, not antiplatelets like Plavix.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Patients with a history of myocardial infarction, stroke, or peripheral artery disease
  • Cardiology clinics and outpatient settings

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?

Documentation must include the indication for Plavix, patient history, and any relevant lab results.

What are the billing considerations?

Ensure correct ICD codes are used to reflect the diagnosis and that documentation supports the medical necessity of Plavix.