ICD-10 Guide

I46

Non-billable

Cardiac arrest

BILLABLE STATUSNo

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/06/2025

Code Description

ICD-10 I46 is a used to indicate a diagnosis of cardiac arrest.

Key Diagnostic Point:

Cardiac arrest is a critical condition characterized by the abrupt cessation of effective cardiac function, leading to the cessation of blood flow to the body. Clinically, it presents with unresponsiveness, absence of breathing, and lack of pulse. The anatomy involved primarily includes the heart, particularly the myocardium, which may fail due to various underlying cardiovascular diseases such as coronary artery disease, arrhythmias, or severe heart failure. Disease progression can be rapid, with irreversible brain damage occurring within minutes if blood flow is not restored. Diagnostic considerations include immediate assessment of the patient's responsiveness and vital signs, followed by advanced cardiac life support (ACLS) protocols to determine the underlying cause, which may include electrocardiogram (ECG) monitoring and laboratory tests. Timely recognition and intervention are crucial for survival and minimizing long-term complications.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

Diagnostic complexity: Requires immediate and accurate diagnosis to initiate life-saving interventions.
Treatment complexity: Involves advanced resuscitation techniques and potential post-arrest care.
Documentation requirements: Detailed documentation of the event, interventions, and patient response is essential.
Coding specificity: Requires precise coding to reflect the cause and nature of the cardiac arrest.

Audit Risk Factors

Common coding errors: Misclassification of the type of cardiac arrest (e.g., primary vs. secondary causes).
Documentation gaps: Incomplete records of the events leading to cardiac arrest.
Billing challenges: Denials may arise from insufficient documentation or incorrect coding of the underlying cause.

Specialty Focus

Medical Specialties

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

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

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

Cardiac arrest has significant clinical implications, as it is a leading cause of mortality worldwide. The population health impact is profound, with survival rates varying widely based on immediate response and quality of care. Quality measures focus on improving bystander CPR rates and access to advanced cardiac life support. Understanding epidemiological trends in cardiac arrest can help healthcare systems allocate resources effectively and implement preventive strategies.

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Reimbursement considerations include the use of appropriate CPT codes for resuscitation efforts and any subsequent care provided. Common denials may occur if documentation does not clearly support the diagnosis of cardiac arrest or if the interventions are not adequately detailed. Best practices include ensuring that all clinical notes are thorough and that coding reflects the urgency and complexity of the care provided.

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 I46?

I46 covers various types of cardiac arrest, including ventricular fibrillation, asystole, and pulseless electrical activity (PEA). It is essential to document the underlying cause, such as myocardial infarction or severe arrhythmias, to provide a complete clinical picture.

When should I46 be used instead of related codes?

I46 should be used when there is a confirmed diagnosis of cardiac arrest, regardless of the underlying cause. It is distinct from codes that describe heart failure or myocardial infarction, which may not involve immediate cessation of cardiac function.

What documentation supports I46?

Documentation should include the patient's clinical presentation, the circumstances leading to the cardiac arrest, interventions performed (e.g., CPR, defibrillation), and any diagnostic tests conducted to ascertain the cause of the arrest.

ICD-10 I46 is a used to indicate a diagnosis of cardiac arrest.