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v1.0.0
ICD-10 Guide
ICD-10 CodesD86.85

D86.85

Billable

Sarcoid myocarditis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D86.85 is a billable code used to indicate a diagnosis of sarcoid myocarditis.

Key Diagnostic Point:

Sarcoid myocarditis is a rare form of myocarditis characterized by the presence of non-caseating granulomas in the myocardium, often associated with systemic sarcoidosis. This condition can lead to inflammation of the heart muscle, resulting in various cardiac complications such as arrhythmias, heart failure, and conduction disturbances. Patients may present with symptoms including chest pain, palpitations, dyspnea, and fatigue. Diagnosis typically involves a combination of clinical evaluation, imaging studies such as echocardiography or MRI, and sometimes endomyocardial biopsy to confirm the presence of granulomas. The management of sarcoid myocarditis may include corticosteroids and other immunosuppressive therapies, depending on the severity of the condition and the presence of systemic involvement. Given its association with systemic sarcoidosis, it is crucial to monitor for other organ involvement, including pulmonary and lymphatic systems, which may complicate the clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of myocarditis
  • Need for comprehensive documentation of systemic sarcoidosis
  • Potential for overlapping symptoms with other cardiac conditions
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of granuloma presence
  • Failure to document systemic sarcoidosis involvement
  • Misclassification with other forms of myocarditis
  • Lack of supporting diagnostic imaging or biopsy results

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Detailed clinical notes on symptoms, diagnostic tests, and treatment plans.

Common Clinical Scenarios

Patients presenting with unexplained heart failure, arrhythmias, or chest pain.

Billing Considerations

Ensure documentation reflects the relationship between sarcoidosis and cardiac symptoms.

Pulmonology

Documentation Requirements

Comprehensive evaluation of pulmonary function and imaging studies.

Common Clinical Scenarios

Patients with sarcoidosis presenting with respiratory symptoms and concurrent cardiac issues.

Billing Considerations

Document any pulmonary involvement to support the diagnosis of sarcoid myocarditis.

Coding Guidelines

Inclusion Criteria

Use D86.85 When
  • According to ICD
  • 10 guidelines, D86
  • 85 should be used when there is clear documentation of sarcoid myocarditis, supported by diagnostic imaging or biopsy results
  • It is important to ensure that the condition is not coded if there is no evidence of granulomatous inflammation in the myocardium

Exclusion Criteria

Do NOT use D86.85 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

93306CPT Code

Echocardiography, transthoracic, real-time with interpretation

Clinical Scenario

Used to assess cardiac function in patients suspected of sarcoid myocarditis.

Documentation Requirements

Document indications for echocardiography and findings.

Specialty Considerations

Cardiology specialists should ensure comprehensive reporting of echocardiographic findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sarcoid myocarditis, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation to support the diagnosis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sarcoid myocarditis, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation to support the diagnosis.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the need for detailed documentation to support the diagnosis.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary treatment for sarcoid myocarditis?

The primary treatment for sarcoid myocarditis typically involves corticosteroids to reduce inflammation and manage symptoms. Additional immunosuppressive therapies may be considered based on the severity of the condition.