Cchis july newsletter 2014

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Atherosclerosis of the extremities (Monckeberg’s Sclerosis) is a peripheral vascular disease (PVD) that occurs in the arteries of extremities; which is why it is sometimes referred to as peripheral artery disease (PAD). The coder however, must have the physician’s documentation indicating the PAD is due to atherosclerosis to ensure correct code assignment.

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Cchis july newsletter 2014

  1. 1. Atherosclerosis of the extremities (Monckeberg’s Sclerosis) is a peripheral vascular disease (PVD) that occurs in the arteries of extremities; which is why it is sometimes referred to as peripheral artery disease (PAD). The coder however, must have the physician’s documentation indicating the PAD is due to atherosclerosis to ensure correct code assignment (see note). PAD due to atherosclerosis is caused by plague made up of deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin built up inside the artery wall. The artery loses its elasticity due to the blockage which gradually develops into complications such as rest pain, intermittent claudication, ulcerations, and even gangrene. NOTE: Peripheral Arterial Disease not specified as atherosclerotic is coded to 443.9, Peripheral Vascular Disease, Unspecified in ICD- 9 CM and I73.9, Peripheral Vascular Disease, Unspecified in ICD-10 CM. WHAT IS ATHEROSCLEROSIS OF THE EXTREMITIES? WHAT TO EXPECT 1 What is Atherosclerosis of the Extremities? 2 Atherosclerosis of Native Arteries of the Extremities 3 Atherosclerosis of Bypass Graft of Extremities & Total Occlusion 4 Requests for Coding Topics “Physician’s documentation must indicate atherosclerosis.” July 2014 Volume 1 Issue 7 By Cynthia Brown, MBA, RHIT, CCS www.cyntcodinghealthinformationservices.com CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984 http://www.cyntcodinghealthinformationservices.com Cynthia@cyntcodinghealthinformationservices.com [phone] CODING YESTERDAY’S NOMENCLATURE TODAY® Coding Atherosclerosis of the Extremities in ICD-9 CM & ICD-10 CM CODING NEWSLETTER FOR HEALTHCARE CODING PROFESSIONALS
  2. 2. Page 2 Coding Yesterday’s Nomenclature Today In ICD-9 CM and ICD-10 CM the codes for atherosclerosis of the extremities are divided into three categories 1) of native arteries of the extremities; 2) of bypass graft of extremities; and 3) chronic total occlusion of artery of the extremities. NATIVE ARTERIES: Use additional code, if applicable to identify chronic total occlusion of artery of the extremities in both ICD-9 CM (440.4) and ICD-10 CM (I70.92) throughout the subcategory. ICD-9 CM: 440.20 Atherosclerosis of the extremities (AOE), unspecified ICD-10 CM: I70.201-I70.209 (The extremity is specified in ICD-10) ICD-9 CM: 440.21 AOE with intermittent claudication ICD-10 CM: I70.211-I70.219 ICD-9 CM: 440.22 AOE with rest pain ICD-10 CM: I70.221-I70.229 ICD-9 CM: 440.23 AOE with ulceration (Use additional code for associated ulceration (707.10-707.19, 707.8, 707.9) ICD-10 CM: I70.231-I70.239 (Use additional code to identify severity of ulcer, L97. - with 5th character 1) OR I70.241-I70.249 (Use additional code to identify severity of ulcer, L97. - with 5th character 2) OR I70.25 (Use additional code to identify severity of ulcer, L98.49-) ICD-9 CM: 440.24 AOE with gangrene (Use additional code for any associated ulceration (707.10-707.19, 707.8, 707.9) ICD-10 CM: I70.261-I70.269 (Use additional code to identify severity of ulcer, L98.49-, IF APPLICABLE) ICD-9 CM: 440.29 Other ICD-10 CM: I70.291-I70.299 REMEMBER IN ICD-10 CM CODES THERE IS A DISTINCTION BETWEEN RIGHT AND LEFT EXTREMITY, BILATERAL, OTHER AND UNSPECIFIED EXTREMITY WHICH IS NOT FOUND IN ICD-9 CM CODES. www.cyntcodinghealthinformationservices.com “Arterial/Venous Circulation in Legs” “Atherosclerosis of extremities divided into 3 categories.” ICD-9 CM and ICD-10 CM CODES
  3. 3. Coding Yesterday’s Nomenclature Today ICD-9 CM and ICD-10 CM CODES Bypass Graft of Extremities: ICD-9 CM: 440.30 of unspecified graft ICD-10 CM: I70.301-I70.309 OR I70.311-I70.319 OR I70.321-I70.329 OR I70.331-339 OR I70.341-I70.349 OR I70.35 OR I70.361-I70.369 OR I70.391- I70.399 *This subcategory requires the coder to use an additional code, if applicable for chronic total occlusion of artery of extremity (I70.92); NOT REQUIRED IN ICD-9 CM. This subcategory includes the complications of the atherosclerosis such as rest pain, intermittent claudication, etc; NOT SEEN IN ICD-9 CM. The coder must follow the instructional note for each complication as described previously. ICD-9 CM: 440.31 of Autologous vein bypass graft ICD-10 CM: I70.401-I70.409 OR I70.411-I70.419 OR I70.421-I70.429 OR I70.431-439 OR I70.441-I70.449 OR I70.45 OR I70.461-I70.469 OR I70.491- I70.499 *This subcategory requires the coder to use an additional code, if applicable for chronic total occlusion of artery of extremity (I70.92); NOT REQUIRED IN ICD-9 CM. This subcategory includes the complications of the atherosclerosis such as rest pain, intermittent claudication, etc; NOT SEEN IN ICD-9 CM. The coder must follow the instructional note for each complication as described previously. ICD-9 CM: 440.32 of Nonautologous biological bypass graft ICD-10 CM: I70.501-I70.509 OR I70.511-I70.519 OR I70.521-I70.529 OR I70.531-539 OR I70.541-I70.549 OR I70.55 OR I70.561-I70.569 OR I70.591- I70.599 *This subcategory requires the coder to use an additional code, if applicable for chronic total occlusion of artery of extremity (I70.92); NOT REQUIRED IN ICD-9 CM. This subcategory includes the complications of the atherosclerosis such as rest pain, intermittent claudication, etc; NOT SEEN IN ICD-9 CM. The coder must follow the instructional note for each complication as described previously. NOTE: ICD-10 CM added a subcategory (I70.601-I70.699) nonbiological bypass graft(s) of the extremities and subcategory (I70.701-I70.799) other type of bypass graft(s) that IS NOT found in ICD-9 CM. The coder should follow the same instructional notes as in the other subcategories. ICD-9 CM: 440.4 chronic total occlusion of artery of the extremities (Code 1st atherosclerosis of arteries of the extremities (440.20-440.29, 440.30-440.32) ICD-10 CM: I70.92 chronic total occlusion of artery of the extremities (Code 1st atherosclerosis of arteries of the extremities (I70.2-, I70.3-, I70.4-, I70.5-, I70.6-, I70.7-) AHIMA approved ICD-10 CM/PCS Trainer ALL THINGS CODING® “Accurate and complete coding is a must in today’s economically challenged healthcare environment.”
  4. 4. Page 4 Coding Yesterday’s Nomenclature Today CCHIS Professional Affiliates AHIMA GHIMA AHIMA approved ICD-10 CM/PCS Trainer EDWOSB/WOSB VOSB SCORE Atlanta CyntCoding Health Information Services P.O. BOX 3019 Decatur, GA 30031 Phone: 404-992-8984 E-Fax: 678-805-4919 E-mail: cyntcoder@cyntcodinghealthinformationservices.com Requests for Coding Topics E-mail your coding topics or request your FREE issue of the CCHIS Newsletter by visiting the website and leaving your contact information. You may also contact me at: cyntcoder@cyntcodinghealthinformationservices.com CCHIS NEWSLETTER TERMS AND CONDITIONS OF USE All content provided in this “CCHIS Newsletter” is for informational purposes only. The owner of this newsletter makes no representations as to the accuracy or completeness of any information in this newsletter or found by following any link in this newsletter. The owner of www.cyntcodinghealthinformationservices.com will not be liable for any errors or omissions in information nor for the availability of this information. The owner will not be liable for any losses, injuries, or damages from the display or use of this information. The terms and conditions are subject to change at any time with or without notice. The owner of http://cyntcodinghealthinformationservices.com will not be liable for any errors or omissions in information nor for the availability of this information. The owner will not be liable for any losses, injuries, or damages from the display or use of this information. The terms and conditions are subject to change at any time with or without notice. CODING YESTERDAY’S NOMENCLATURE TODAY® www.cyntcodinghealthinformationservices.com

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