Afib ICD 10 Code – Atrial Fibrillation

In this topic will see the types of Afib, symptoms, Afib ICD 10 Code and its guidelines along with examples.

Atrial Fibrillation is an irregular (often rapid) heartbeat which may lead to blood clot in the heart and travel to other parts of the body and make blocks. Afib itself is not fatal but it is critical when it leads to stroke or heart failure. Hence Afib needs to be managed.

Types of Afib:

There are different types of afib based on how long it lasts.

• Persistent – Lasts more than 7 days and it needs an intervention to restore the rhythm.
• Chronic (Permanent) – Chronic stays more than 12 months and it is called permanent when the abnormal heart rhythm cannot be restored.
• Paroxysmal – Occurs occasionally and lasts for few seconds or hours or few days (less than 7 days) and stop spontaneously.

Symptoms and Tests:

Some people may not have any symptoms until it is found by physician in physical examination. Common symptoms occur are palpitation, shortness of breath, chest pain, fatigue, dizziness, lightheadedness and reduced ability to exercise.

Physician finds out Afib by checking the signs and symptoms and physical examination. Tests to be used to detect Afib are electrocardiogram, echocardiogram, holter monitor, stress test and chest X-ray.

Afib can be managed with anti-arrhythmic or anticoagulant drugs. Even after doing ablation procedure to correct Afib there may be need of medication.

Afib ICD 10 Code list and guidelines:

Afib ICD 10 codes and guidelines can be found in chapter 9 of ICD-10-CM manual which is “diseases of the circulatory system”, code range I00 – I99

Coders need to note that there are codes available for atrial fibrillation as per the type. Hence it is important to evaluate the medical record properly to assign highly specified code.

Afib ICD 10 codes	Description
I48.0	Afib: Paroxysmal
I48.11	: Longstanding persistent
I48.19	: Other persistent
I48.20	: Chronic
I48.21	: Permanent
I48.3	: Typical
I48.4	: Atypical
I48.91	Afib unspecified

• Only one type of Afib code should be assigned in a chart as per the severity. For example, code only permanent afib when both chronic and permanent is mentioned in a chart.

Table below shows the type to be coded when multiple types are documented

Types of Afib found in medical record	Type to be coded
Chronic afib, Permanent Afib	Permanent (I48.21)
Chronic persistent Afib	Persistent (I48.19)
Afib with rapid ventricular response (RVR)	Unspecified afib (I48.91)
Paroxysmal Afib, Persistent Afib	Persistent (I48.19)

• Atrial fibrillation can be coded when managed with a medication even though patient is not experiencing any irregular rhythm.

Below are few examples on Afib coding.

Afib ICD 10 Example 1

77 year old female presents for an annual wellness examination. She states her weight is getting increased in the past 3 months. Patient has a history (Hypertension and High cholesterol). Her medication list was reviewed which includes lisinopril and atorvastatin. Vitals noted as BP of 135/80 mmHg, pulse 120 bpm at rest and BMI 22. Her physical examination shows normal without any evidence of heart or lung abnormalities. An electrocardiogram was performed which shows atrial fibrillation with RVR. Physician has prescribed anticoagulants to manage Afib further.

ICD-10 codes for this scenario would be:

I48.91 – Atrial fibrillation unspecified

E78.00 – High cholesterol

I10 – Hypertension

Note: Afib with rapid ventricular response (RVR) should be coded as unspecified afib.

Afib ICD 10 Example 2

Peter, 67 year old male presents to emergency department with palpitations, shortness of breath and fatigue from past 10 days. He has a history of hypertension, GERD, chronic afib and diabetes. His current medications are metformin, omeprazole, lisinopril and xarelto. Vitals were obtained which showed BP of 88/60 mmHg, pulse 140 BPM and respiratory rate of 24/min. Cardiac exam reveals irregularly regular rhythm. A chest X-ray, blood tests and Electrocardiogram was ordered. Physician reviewed all the test results and diagnosed as chronic persistent afib. Patient is admitted for an ablation procedure and further checkup.

ICD-10 Codes for this scenario would be:

I48.19 – Persistent afib

I10 – Hypertension

K21.9 – GERD

E11.9 – Diabetes Mellitus

Note: When both chronic and persistent afib mentioned code only persistent as per guideline.