Health Information Management

Q&A: Coding PTCA in ICD-10-PCS

JustCoding News: Inpatient, October 24, 2012

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Q: Can you explain how we would code a percutaneous transluminal coronary angioplasty (PTCA) using ICD-9-CM vs. ICD-10-PCS? 

A: For the purposes of your question, let’s consider a patient who undergoes a PTCA involving one site and one stent.
 
First, note that ICD-10-PCS classifies the coronary arteries as a single body part that is further specified by the number of sites treated—not by the name or number of arteries.
 
In ICD-9-CM, report the following codes:
  • 36.06 (insertion of non-drug-eluting coronary stent)
  • 00.66 (angioplasty [PTCA])
  • 00.45 (insertion of one vascular stent)
  • 00.40 (procedure on single vessel)
  • 00.44 (procedure on vessel bifurcation)
In ICD-10-PCS, report 02703D6. Each component of this code denotes the following:
  • 0 (medical/surgical [procedure])
  • 2 (heart and great vessels [body system])
  • 7 (dilation [root operation])
  • 0 (coronary artery, one site [body part])
  • 3 (percutaneous [approach])
  • D (intraluminal device [bare metal stent])
  • 6 (bifurcation)
As stated previously, the ICD-9-CM codes focus on capturing the number of stents and vessels whereas ICD-10-PCS focuses on capturing the number of sites treated. One ICD-10-PCS code provides all of the necessary information to completely capture this procedure.
 
Editor’s note: Mary H. Stanfill, MBI, RHIA, CCS, CCS-P, FAHIMA, vice president of HIM consulting services at United Audit Systems, Inc. in Cincinnati, Ohio, answered the previous question during HCPro’s audio conference Mastering Physician Queries: Tools for Effective Policies, Practices, and ICD-10 Preparation.
 
This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
 
Need expert coding advice? Submit your question to Senior Managing Editor Michelle Leppert, CPC, at mleppert@hcpro.com, and we’ll do our best to get an answer for you.



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