Reporting Endarterectomy in addition to the bypass in ICD-10-PCS

Reporting Endarterectomy in addition to the bypass (same vessel) in ICD-10-PCS

If the endarterectomy is performed in the same artery that is bypassed no additional code would be reported for the separate endarterectomy. The endarterectomy is considered integral part of the bypass procedure. Most often, the endarterectomy is performed to help facilitate the anastomosis/bypass.

If there is a separate objective documented for the endarterectomy then it would be appropriate to report in addition. If the endarterectomy is performed on a separate artery than the bypassed artery with a separate objective than to facilitate bypass it would be appropriate to report in addition.

For example, if a patient undergoes left carotid endarterectomy and then left to right carotid-carotid bypass with PTFE graft, both of these procedures would be coded. 03CN0ZZ, extirpation of matter from left external carotid artery, open approach, and 031J0JJ, bypass left common carotid artery to right extracranial artery with synthetic substitute, open approach. These PCS codes are discussed in Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2017, Page 64.

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

References:
AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, Fourth Quarter 2017, Page 64
AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, Fourth Quarter 2015, Pages 20 & 21. This is the basis of this coding tidbit.
AHA Coding Clinic for ICD-9-CM, Third Quarter 1993, Pages 7 & 8.

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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.