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.
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