Rheumatic chorea without heart involvement
ICD-10 I02.9 is a billable code used to indicate a diagnosis of rheumatic chorea without heart involvement.
Rheumatic chorea, also known as Sydenham's chorea, is a neurological disorder characterized by involuntary, rapid, and irregular movements, primarily affecting the face, hands, and feet. It is a complication of rheumatic fever, which is a consequence of untreated streptococcal throat infection. The condition typically arises in children and adolescents, often following a streptococcal infection, and is not associated with heart involvement in this specific coding. The pathophysiology involves an autoimmune response where antibodies produced against streptococcal bacteria mistakenly attack the basal ganglia in the brain, leading to the characteristic chorea. Diagnosis is primarily clinical, based on the presence of chorea and a history of rheumatic fever, with no evidence of cardiac involvement. Diagnostic considerations include ruling out other causes of chorea, such as Huntington's disease or drug-induced movements. Treatment focuses on symptomatic relief, often utilizing antiepileptic medications or neuroleptics, and addressing any underlying streptococcal infection with antibiotics.
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
I02.9 specifically covers rheumatic chorea that occurs without any associated heart involvement. It is important to differentiate this from other forms of chorea and rheumatic fever complications that may affect the heart.
I02.9 should be used when the patient presents with chorea following rheumatic fever but shows no signs of heart involvement. If cardiac symptoms are present, I02.0 should be used instead.
Documentation should include a clear history of rheumatic fever, clinical findings of chorea, and explicit statements indicating the absence of heart involvement. Neurological assessments and treatment plans should also be documented.
