How to Code Coronary Artery Disease Using ICD 10 and CPT Codes

How to Code Coronary Artery Disease Using ICD-10 and CPT Codes

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Coronary artery disease occurs due to the narrowing of the coronary arteries. The article discusses the medical codes used to report this disorder.

Coronary artery disease (CAD) `develops due to the narrowing and hardening of the coronary arteries, (the blood vessels that supply oxygen and blood to the heart). Regarded as the leading cause of death for both men and women in the United States, CAD begins when hard cholesterol substances (plaques) thatget deposited within a coronary artery results in the formation of tiny clots that can obstruct the flow of blood to the heart muscle.Early-stage coronary artery disease often may not generate any symptoms. However, the problem gets diagnosed only when a routine checkup reveals a high cholesterol/blood pressure levels or when the patient suffers a significant blockage or heart attack.The condition is characterized by common symptoms like chest pain (angina pectoris), heart attack (myocardial infarction), sweating, shortness of breath and sudden death.Cardiologists treating this condition must document the diagnosis and medical procedures with accurate medical codes. Medical coding outsourcing can ensure timely and accurate claim submission for optimal reimbursement for the medical services provided.

Also called coronary heart disease (CHD), CAD is the most common form of heart disease that affects about 16.5 million Americans above the age of 20. Reports suggest that every 40 seconds, one person in the US suffers a heart attack. A heart attack can come from uncontrolled CAD. Incorporating positive lifestyle changes can help to prevent and treat coronary artery disease.

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Signs and Symptoms Chest discomfort (angina) is one of the most common symptoms of coronary artery disease. Some of the other related symptoms are –  Pain in the arms or shoulders  Shortness of breath  Sweating  Dizziness  Nausea  Irregular heartbeat  Restlessness  Perspiration and clammy skin Generally, a number of risk factors can directly contribute to this condition. The potential risk factors include – age, family history, sex, smoking, physical inactivity, obesity, stress, diabetes, high blood pressure and high cholesterol levels. A correct understanding about the potential risk factors can help people to prevent or reduce the likelihood of developing this disorder.

How to Diagnose and Document CAD Diagnosing coronary artery disease requires a detailed review of medical history, physical examination, routine blood test and other diagnostic tests such as - Electrocardiogram (ECG), angiogram, cardiac catheterization (left heart catheterization), echocardiogram, stress test www.outsourcestrategies.com

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and heart CT scan. Treatment for this condition involves lifestyle changes,

and

possibly

some

medical

procedures

and

medications.Lifestyle recommendations include quitting the habit of smoking, reducing or stopping the consumption of alcohol, losing body weight to a healthy level, eating a healthy diet, and exercising regularly.

Medications include – statins, calcium channel blockers, Beta blockers and Angiotensin-converting enzyme (ACE) inhibitors. If your condition doesn’t improve with lifestyle changes and medications, physicians may recommend several procedures to increase blood flow to your heart and these include - balloon angioplasty, coronary bypass surgery, enhanced external counter pulsation and stent placement.

Medicare Part B covers screening blood tests for lipids, cholesterol, and triglycerides once every 5 years to identify potential risk factors (like heart attack or stroke) for cardiovascular diseases. In addition to Medicare coverage, private insurance companies offer Medicare Supplement plans.

Cardiology medical coding involves the use of specific ICD-10 codes and CPT codes to document different cardiovascular conditions, including coronary artery disease (CAD). Medical codes used for documenting this disorder include –

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ICD-10 Codes  I25 – Chronic ischemic heart disease  I25.1 – Atherosclerotic heart disease of native coronary artery  I25.10 – Atherosclerotic heart disease of native coronary artery, without angina pectoris  I25.11 – Atherosclerotic heart disease of native coronary artery with angina pectoris  I25.110 – Atherosclerotic heart disease of native coronary artery with unstable angina pectoris  I25.111 – Atherosclerotic heart disease of native coronary artery with unstable angina pectoris, with documented spasm  I25.118 – Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris  I25.119 – Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris CPT Codes  92920 - Percutaneous transluminal coronary angioplasty; single major coronary artery or branch  92921- Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery  92924 - Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch www.outsourcestrategies.com

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 92925 - Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery  92928 - Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch  92929 - Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery  92933 - Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch  92934 - Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery  92937 - Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel  92938 - Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and

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angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft  92941 - Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel  92943 - Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel  92944 - Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft  92973 - Percutaneous transluminal coronary thrombectomy mechanical (List separately in addition to code for primary procedure)  92974 - Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure)  92975 - Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography www.outsourcestrategies.com

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 92978 - Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel  92979 - Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel  93454 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation  93455 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography  93456 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization

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 93457 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization  93458 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed  93459 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography  93460 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed

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 93461 - Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography  93571 - Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel  93572 - Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; each additional vessel HCPCS Code  C9600 - Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch  C9601 - Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery

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 C9602 - Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch  C9603 - Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)  C9604 - Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel Healthcare providers and coding specialists must have the knowledge and expertise to code each separate procedurecorrectly to avoid claim denials and delayed payment. Outsourcing these coding tasks to a reliable medical billing and coding company that offers the services of AAPC-certified coders can make the coding process easy.

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