The confluence of race and heart disease.

February is the month that we celebrate American Heart Month and Black History Month. You may wonder why these are being discussed together in a coding article. Heart disease is the leading cause of death for Black Americans, at 23.5 percent. Black Americans are also at risk for hypertension, hyperlipidemia, heart failure, and diabetes.

Diabetes is the seventh-leading cause of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). In 2018, a total of 10.5 percent of the Black population (34.2 million) had diabetes. Diabetes increases the risk of heart disease. According to the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH), minorities have a higher risk of incidence of diabetes. The prevalence of diabetes among Medicare beneficiaries is:

          American Indian/Alaskan Native               40%

          Black/African American                             38%

          Hispanic                                                    38%

          Asian/Pacific Islander                                37%

          White                                                         25%

Heart failure is suffered by 6.5 million adults in the U.S. annually. The incidence of heart failure is decreasing, going from 16.6 percent of Medicare beneficiaries in 2009 to 14.5 percent in 2018. When we look at the prevalence among Medicare beneficiaries by race/ethnicity, there are some concerning numbers:

          Black/African American                             17%

          American Indian/Alaskan Native               15%

          White                                                        14%

          Hispanic                                                   13%

          Asian/Pacific Islander                               11%

Hyperlipidemia is the condition of high levels of fats in the blood, which afflicts 71 million Americans. According to CMS, 48 percent of American beneficiaries had claims with this diagnosis in 2018. By ethnicity/race, the rates are:

          Asian/Pacific Islander                        51%

          White                                                 49%

          Hispanic                                            44%

          Black/African American                     43%

          American Indian/Alaskan Native       35%

Hypertension is a common diagnosis around the world. According to the CDC, 45 percent of adults in the U.S. have hypertension. The risk of hypertension increases with age, as greater than 75 percent of adults over the age of 60 have the disease, which is a risk factor for coronary artery disease, stroke, congestive heart failure, and end-stage renal disease. The prevalence across race/ethnicity shows:

          Black/African American                    65%

          Asian/Pacific Islander                       57%

          White                                                57%

          Hispanic                                           56%

          American Indian/Alaskan Native      54%

The CMS Office of Minority Health has the charge of eliminating health disparities and improving health of minority populations. Medicare and many health plans cover preventative screening to assist beneficiaries in identifying these conditions early. Make the most of your insurance coverage by:

    1. Confirming your coverage;
    2. Knowing where to go to get answers;
    3. Finding a provider;
    4. Making an appointment; and
    5. Filling your prescription(s).

From an ICD-10-CM perspective, the codes for heart disease, heart failure, and hypertension are found in Chapter 9 (Diseases of the Circulatory System). The diagnosis codes will begin with the letter “I,” such as I10, I11.0, and I50.9. The codes for diabetes and hyperlipidemia are found in Chapter 4 (Endocrine, Nutritional, and Metabolic Diseases). These codes will begin with the letter “E,” such as E78.5 and E11.9. The Official Coding and Reporting Guidelines address code combinations and sequencing in these respective chapters.

Do not forget your preventative health screening during National Heart Month, regardless of your ethnic/racial background!

Programming Note: Listen to Laurie Johnson report this story live today during Talk Ten Tuesdays 10 a.m. Eastern.



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