Health Information Management

Bypass problems when coding CABG

HIM-HIPAA Insider, December 8, 2014

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

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.

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular