I49.02
BillableVentricular flutter
HCC Category Mapping
V28HCC 213 — Cardio-Respiratory Failure and Shock
0.000V24HCC 84 — Cardio-Respiratory Failure and Shock
0.402ESRDHCC 84 — Cardio-Respiratory Failure and Shock
0.000What This Code Means
A serious heart rhythm disorder where the lower chambers of the heart beat very rapidly in a coordinated but ineffective pattern, reducing blood flow to the body.
Coding Tips
- •Distinguish between ventricular flutter and ventricular fibrillation, as flutter has more organized electrical activity
- •Document the duration and response to treatment for clinical context
Clinical Significance
Ventricular flutter is a severe, life-threatening arrhythmia characterized by rapid, organized ventricular contractions that significantly reduce cardiac output. It often degenerates into ventricular fibrillation if untreated. Survivors require intensive cardiac monitoring, possible implantable cardioverter-defibrillator placement, and long-term management.
Documentation Requirements
- ✓Provider must clearly document 'ventricular flutter' as the specific arrhythmia
- ✓Clinical context — whether active, resolved, or historical diagnosis
- ✓Underlying cardiac pathology contributing to the arrhythmia
- ✓Current treatment and prevention strategy including device therapy
- ✓Hemodynamic impact and response to treatment
- ✓Differentiation from ventricular fibrillation and ventricular tachycardia in the clinical notes
Commonly Confused Codes
I49.01 — Ventricular fibrillation: chaotic ventricular activity vs flutter's more organized rapid rhythmI47.2 — Ventricular tachycardia: organized ventricular rhythm typically at 150-250 beats per minute vs flutter at 250-350 beats per minuteI48.92 — Unspecified atrial flutter: flutter originating in the atria, not the ventriclesI46.2 — Cardiac arrest due to underlying cardiac condition: the clinical event vs the underlying rhythmI49.9 — Cardiac arrhythmia, unspecified: nonspecific code that should not be used when flutter is documented
Code Hierarchy
└I49Other cardiac arrhythmias└I49.0Ventricular fibrillation and flutter└I49.02Ventricular flutter
└I49.02Ventricular flutter