---
title: Endarterectomy During Coronary Artery Bypass
description: Lately we have seen several cases where the endarterectomy was assigned along with the coronary artery bypass (CABG) procedure when being performed on the same vessel to facilitate the CABG. A coronary artery endarterectomy is not always performed during a CABG procedure, so when it is performed it becomes confusing...
image: https://hiacode.com/hubfs/Imported_Blog_Media/iStock-1162543608-1.jpg
---

# Endarterectomy During Coronary Artery Bypass

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Jan 22, 2024

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Lately we have seen several cases where the endarterectomy was assigned along with the coronary artery bypass (CABG) procedure when being performed on the same vessel to facilitate the CABG.

 

A coronary artery endarterectomy is not always performed during a CABG procedure, so when it is performed it becomes confusing as to whether to code it separately or not.

## Questions to ask yourself when coding endarterectomy at same time as CABG:

- **Is the endarterectomy performed to facilitate the anastomosis?**  
  Yes-don’t code  
  No-separate code may be necessary
- **Is the endarterectomy performed because of occluded and/or calcified vessels making the CABG technically impossible?**  
  Yes-don’t code  
  No-separate code may be necessary
- **Is the endarterectomy performed to make the CABG easier?**  
  Yes-don’t code  
  No-separate code may be necessary
- **Was there a separate and distinct objective for the endarterectomy?**  
  Yes-separate code may be necessary  
  No-don’t code
- **Is the endarterectomy performed on another vessel than the one that is being bypassed?**  
  Yes-separate code may be necessary  
  No-don’t code

There may be other questions and scenarios that come up, but these are the common questions that coders should ask themselves while assigning PCS codes for CABG with endarterectomy. The most recent official coding advice from AHA Coding Clinic for ICD-10-CM/PCS, Third Quarter 2018: Page 26 states “when the endarterectomy is done to prepare the artery for the bypass surgery the endarterectomy would not be coded separately. The endarterectomy is only reported when there is a separate and distinct procedural objective.” This is very similar advice that we followed prior to ICD-10-CM/PCS implementation.

***Authored by Kim Boy, RHIT, CDIP, CCS, CCS-P***

***References***  
*AHA Coding Clinic for ICD-10-CM/PCS, Third Quarter 2018: Page 26*  
*AHA Coding Clinic, Third Quarter 1993, Page: 7 to 8*  
*ICD-10-PCS Official Guidelines for Coding and Reporting 2020, Page: 5 to 6*

---

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