Health Information Management

Bypass problems when coding CABG

HIM-HIPAA Insider, December 8, 2014

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When coders hear the term bypass, they may think first of a coronary artery bypass graft (CABG) procedure. It's among the most commonly performed major operations, according to the American Heart Association.
 
CABG improves the blood flow to the heart muscle in people with coronary artery disease (CAD), a condition where the coronary arteries are narrowed by a buildup of fatty material within the arterial walls. In a CABG procedure, the surgeon uses a vascular graft (often from the patient) to divert the blood flow around the blockage or narrowing caused by CAD.
 
In ICD-9-CM Volume 3, the codes for CABG procedures are located in the 36.1 series (bypass anastomosis for heart revascularization). ICD-9-CM differentiates between an aortocoronary bypass graft and an internal mammary artery bypass graft, says Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, director of coding and HIM for HCPro, a division of BLR, in Danvers, Massachusetts. These are the two most common methods of performing a CABG procedure.
 
The codes in ICD-9-CM Volume 3 are broken down by the number of arteries bypassed, from one to four or more with aortocoronary bypass and two choices (single or double) for the internal mammary artery bypass. ICD-9-CM Volume 3 considers the harvesting of graft material to be an integral part of the procedures, so coders do not report it separately, McCall says. "The grafts are not separately reportable when the physician harvests the saphenous vein, for example. It's really about whether they performed an aortocoronary bypass or an internal mammary bypass to select the appropriate code."
 
Continue reading "Bypass problems when coding CABG" on the HCPro website. Subscribers to Briefings on Coding Compliance Strategies have free access to this article in the December issue.



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