I48.3
BillableTypical atrial flutter
HCC Category Mapping
V28HCC 238 — Specified Heart Arrhythmias
0.000V24HCC 96 — Specified Heart Arrhythmias
0.282ESRDHCC 96 — Specified Heart Arrhythmias
0.000RxHCCHCC 193 — Specified Heart Arrhythmias
0.000What This Code Means
A rapid, regular irregular heartbeat in the upper chambers of the heart characterized by a distinctive sawtooth pattern on an electrocardiogram.
Coding Tips
- •Atrial flutter is distinct from atrial fibrillation; flutter has a regular rate while fibrillation is irregular
- •Document the type of flutter (typical/atypical) and whether it is paroxysmal, persistent, or permanent
Clinical Significance
Typical atrial flutter is a macro-reentrant atrial arrhythmia involving the cavotricuspid isthmus, producing a characteristic sawtooth pattern on electrocardiogram. It is highly amenable to catheter ablation with cure rates exceeding 90%. While distinct from atrial fibrillation, it carries similar stroke risk and anticoagulation requirements.
Documentation Requirements
- ✓Provider diagnosis of typical (cavotricuspid isthmus-dependent) atrial flutter
- ✓Electrocardiogram showing sawtooth flutter waves, typically with 2:1 or 4:1 conduction
- ✓Ventricular rate and hemodynamic stability documented
- ✓Stroke risk assessment and anticoagulation plan
- ✓Treatment approach (rate control, rhythm control, catheter ablation consideration)
Commonly Confused Codes
I48.4 — Atypical atrial flutter; does not involve the cavotricuspid isthmus, different ablation approachI48.0 — Paroxysmal atrial fibrillation; irregular rhythm, not organized flutter wavesI48.92 — Unspecified atrial flutter; use only when typical vs atypical cannot be determinedI47.10 — Supraventricular tachycardia, unspecified; different arrhythmia mechanism