THE CODING EDGE® ARCHIVES

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Procedure Practice 12/15/97 - Feature Article 12/15/97
   

Procedure Practice 12/15/97:
Coding Recommendations

  
Listed below are the ICD-9-CM diagnosis and procedure codes as well as the CPT-4 procedure codes that we think properly classify this episode of treatment. Please note that modifiers, used only for physician billing purposes, have not been assigned to the CPT-4 codes.
   

Suggested Code Assignments

The patient’s preoperative workup demonstrated plaque formation in both the right and left internal carotid arteries. Assign ICD-9-CM code 433.30, Occlusion and stenosis of precerebral arteries, multiple and bilateral, without mention of cerebral infarction, to reflect this diagnostic statement.

The correct ICD-9-CM procedure code is 38.12, Incision, excision and occlusion of vessels; endarterectomy of other vessels of the head and neck. Notes accompanying this code in the tabular list indicate that the patch graft is included, therefore no additional ICD-9-CM procedure codes are needed.

Assign CPT-4 procedure code 35301, Thromboendarterectomy, with or without patch graft; carotid, vertebral, subclavian, by neck incision, and 35390, Reoperation, carotid, thromboendarterectomy, more than one month after original operation. Note that code 35390 must be listed separately in addition to the code for the primary procedure and must only be used with code 35301.

         
Bibliography - References:
St. Anthony’s Illustrated ICD-9-CM Code Book, St. Anthony’s Publishing, Reston VA.
CPT 97, Physicians’ Current Procedural Terminology, American Medical Association, Chicago, IL.
Aldridge, Samuel MD and Anderson, Robert, MD "An Overview of Vascular Procedures," educational presentation, Lakes Region General Hospital, Laconia, NH, September 1996.		 Notice: This part of our web site was prepared to assist in understanding and maintaining good coding skills. For proper use of this feature, reference must be made to official coding guidelines when necessary. The information here presented is only to be used as a supplement to those guidelines. Laguna Medical Systems, Inc., makes no representations or guarantees as to amounts that will be paid by Medicare or other third party payers.

 

Please be aware that the Coding Edge® Archive pages are NOT retroactively updated
to reflect possible coding rules and regulation changes made after the publishing date.