PFO ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for PFO

These PFO ICD-10 codes cover a range of cardiovascular and cerebrovascular conditions, reflecting the diverse clinical manifestations of this congenital heart anomaly. The codes help accurately document and classify cases involving PFO for medical and billing purposes.

• I25.10 - Atherosclerotic heart disease of the native coronary artery without angina pectoris: This code is used when a PFO is associated with atherosclerotic heart disease of the native coronary artery without angina pectoris. PFOs may contribute to the development or exacerbation of coronary artery disease.
• I27.0 - Primary pulmonary hypertension: PFOs are linked to primary pulmonary hypertension. This code applies when PFO is identified with primary pulmonary hypertension. PFOs can cause paradoxical embolisms that affect pulmonary circulation.
• I67.89 - Other specified cerebrovascular diseases: PFOs are linked to cryptogenic strokes. This code indicates PFO involvement in cerebrovascular diseases not classified elsewhere. Emboli passing through PFO can cause cryptogenic strokes.
• I21.9 - Acute myocardial infarction, unspecified: PFOs are linked to paradoxical embolisms causing myocardial infarction. This code applies to PFO-associated acute myocardial infarction when the cause is unknown.
• Q25.9 - Congenital heart disease, unspecified: PFO code is used for cases where a congenital heart anomaly is acknowledged without further specification.
• I26.9 - Pulmonary embolism without mention of acute cor pulmonale: PFOs are associated with an increased risk of paradoxical embolisms leading to pulmonary embolism. This code is used when a PFO is linked to a pulmonary embolism without acute cor pulmonale.
• I21.0 - Acute transmural myocardial infarction of the anterior wall: In cases where a PFO is associated with an acute transmural myocardial infarction specifically affecting the anterior wall of the heart, this code is applicable.
• I63.50 - Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery: PFOs are often implicated in cryptogenic strokes, and this code is used when a cerebral infarction occurs due to an unspecified occlusion or stenosis, likely related to a PFO.
• I35.0 - Nonrheumatic aortic (valve) stenosis: PFOs may contribute to embolic events, including aortic valve stenosis. This code is applicable when a PFO is associated with nonrheumatic aortic valve stenosis.
• G45.9 - Transient cerebral ischemic attack, unspecified: PFOs are often investigated in transient ischemic attacks (TIAs) cases. This code is used when a TIA occurs, and the specific cause, including the potential involvement of a PFO, is not specified.

Which PFO ICD Codes are billable

• I25.10 - Atherosclerotic heart disease of the native coronary artery without angina pectoris: Yes
• I27.0 - Primary pulmonary hypertension: Yes
• I67.89 - Other specified cerebrovascular diseases: Yes
• I21.9 - Acute myocardial infarction, unspecified: Yes
• Q25.9 - Congenital heart disease, unspecified: Yes
• I26.9 - Pulmonary embolism without mention of acute cor pulmonale: Yes
• I21.0 - Acute transmural myocardial infarction of anterior wall: Yes
• I63.50 - Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery: Yes
• I35.0 - Nonrheumatic aortic (valve) stenosis: Yes
• G45.9 - Transient cerebral ischemic attack, unspecified: Yes

All the listed ICD-10 codes for PFO-related conditions are generally billable. These codes are used for specific diagnoses related to PFO and associated cardiovascular or cerebrovascular conditions. 

Proper coding is essential for accurate billing and reimbursement in healthcare settings. Always consult the latest coding guidelines and regulations to ensure accurate and up-to-date billing practices.

Clinical information

• A congenital heart abnormality is characterized by an opening in the septum (wall) between the heart's two upper chambers (atria).
• PFO is present in approximately 25% of the general population.
• Many individuals with PFO remain asymptomatic throughout their lives, while others may experience symptoms or complications.
• PFO is often investigated in cryptogenic strokes (strokes of unknown origin).
• PFO allows blood clots or other particles to travel from the venous to the arterial circulation, potentially reaching the brain and causing a stroke.
• Some studies suggest a potential association between PFO and migraines.
• Percutaneous closure of PFO has been explored as a treatment option for reducing migraine frequency in specific individuals.
• PFO has been associated with decompression illness in divers.
• Nitrogen bubbles formed during diving can cross the PFO and lead to symptoms known as "the bends."
• PFO allows venous blood, including clots or other debris, to bypass the lungs and enter the systemic circulation, leading to paradoxical embolism.
• Paradoxical embolisms may result in conditions such as pulmonary embolism, myocardial infarction, or stroke.
• Echocardiography, including transesophageal echocardiography (TEE), is commonly used to diagnose and assess the severity of PFO.
• Contrast agents may be used during echocardiography to detect the passage of blood through the PFO.
• Medications, such as anticoagulants, may be prescribed to reduce the risk of clot formation.
• Percutaneous closure procedures involve the placement of a closure device to seal the PFO, reducing the risk of paradoxical embolism.
• Decision-making regarding treatment often considers the patient's clinical presentation, age, overall health, and the presence of associated conditions.
• Regular follow-up and monitoring may be recommended, especially after closure procedures.

Synonyms include

• Atrial Septal Defect (ASD)
• Interatrial Communication
• Septal Puncture
• Foramen Ovale Persistens
• Interatrial Septal Anomaly