Now that we’ve reviewed the ICD-10-PCS guidelines relevant to procedures performed on coronary arteries, let’s look at a few case studies comparing ICD-9-CM to ICD-10-PCS.Ħ6-year-old with severe CAD is admitted for CABG x 3 using the left internal mammary artery (LIMA) to the left anterior descending (LAD), radial artery free graft from aorta to diagonal branch, and saphenous vein graft (SVG) from the aorta to the right coronary artery (RCA).
Separate body part values are used to specify the number of sites treated when the same procedure is performed on multiple sites in the coronary arteries.Įxamples: Angioplasty of two distinct sites in the left anterior descending coronary artery with placement of two stents is coded as Dilation of Coronary Arteries, Two Sites, with Intraluminal Device.Īngioplasty of two distinct sites in the left anterior descending coronary artery, one with stent placed and one without, is coded separately as Dilation of Coronary Artery, One Site with Intraluminal Device, and Dilation of Coronary Artery, One Site with no device. The coronary arteries are classified as a single body part that is further specified by number of sites treated and not by name or number of arteries. If multiple coronary artery sites are bypassed, a separate procedure is coded for each coronary artery site that uses a different device and/or qualifier.Įxample: Aortocoronary artery bypass and internal mammary coronary artery bypass are coded separately. Rather than identifying the body part bypassed from, the body part identifies the number of coronary artery sites bypassed to, and the qualifier specifies the vessel bypassed from.Įxample: Aortocoronary artery bypass of one site on the left anterior descending coronary artery and one site on the obtuse marginal coronary artery is classified in the body part axis of classification as two coronary artery sites and the qualifier specifies the aorta as the body part bypassed from.
Coronary artery bypass procedures are coded differently than other bypass procedures as described in the previous guideline. There are a few specific guidelines associated with procedures done on the coronary arteries in ICD-10-PCS which need to be reviewed.Ĭoronary arteries are classified by number of distinct sites treated, rather than number of coronary arteries or anatomic name of a coronary artery (e.g., left anterior descending).
In honor of American Heart Month, this month’s Code Cracker explores the guidelines for coding heart procedures. The coding of heart procedures is done very differently in ICD-9-CM versus ICD-10-PCS. Tune in to this monthly online coding column to learn from AHIMA’s coding experts about challenging areas and documentation opportunities for ICD-10-CM/PCS.