Inferior sinus venosus atrial septal defect
ICD-10 Q21.15 is a billable code used to indicate a diagnosis of inferior sinus venosus atrial septal defect.
Inferior sinus venosus atrial septal defect (ASD) is a congenital heart defect characterized by an abnormal opening between the right atrium and left atrium, specifically located near the inferior vena cava. This defect allows oxygen-rich blood from the left atrium to flow into the right atrium, leading to increased blood flow to the right side of the heart and lungs. Over time, this can result in right atrial and ventricular enlargement, pulmonary hypertension, and heart failure if left untreated. Patients may present with symptoms such as exercise intolerance, fatigue, and palpitations, although many may remain asymptomatic in early childhood. Diagnosis typically involves echocardiography, which can visualize the defect and assess hemodynamic significance. Treatment options may include surgical repair or catheter-based interventions, depending on the size of the defect and the presence of associated anomalies. Early detection and management are crucial to prevent long-term complications associated with this condition.
Pediatric documentation should include growth parameters, developmental milestones, and specific symptoms related to the congenital heart defect.
Common scenarios include routine pediatric check-ups where a heart murmur is detected, leading to further evaluation and diagnosis of ASD.
Consideration must be given to the age of the patient and the timing of interventions, as well as the potential for long-term follow-up.
Genetic documentation should include family history of congenital heart defects and any genetic syndromes associated with ASD.
Scenarios may involve genetic counseling for families with a history of congenital heart disease or syndromic presentations.
Genetic testing may be indicated in cases with multiple congenital anomalies or family history of chromosomal abnormalities.
Used when a patient undergoes surgical closure of an inferior sinus venosus ASD.
Operative report detailing the procedure and any complications.
Pediatric cardiology specialists should provide detailed operative notes.
Accurate coding of inferior sinus venosus ASD is crucial for appropriate management and treatment planning. It ensures that healthcare providers can track outcomes, allocate resources effectively, and provide the necessary follow-up care for patients with this congenital condition.
