In order for coders to correctly report the use of an IABP in ICD-10-PCS, the coder first must understand what the balloon pump is and what it is providing for the patient.
What is the IABP?
The IABP is a polyethylene balloon mounted on a flexible catheter that is inflated with gas (typically helium).
How is the IABP inserted into the patient?
Typically the balloon/catheter is inserted through the femoral artery into the descending aorta. The other end of the catheter is attached to a computer console that contains a pump and inflates and deflates the balloon with the rhythm of the heart.
What does the IABP do/what is the function?
This device helps the heart to pump blood. The balloon is inserted to provide circulatory support in patients by inflation (during diastole) and deflation (during systole) of the balloon during the cardiac cycle. During diastole, the balloon is filled with helium which causes the blood to be displaced from the increased balloon volume. The aortic pressure is then increased which increases the blood flow to the coronary arteries. The opposite occurs during systole. The IABP helps to mechanically support the heart to create a balance of myocardial oxygen supply and demand by inflating and deflating and this is called counter-pulsation.
Why would a patient require an IABP?
- Cardiogenic Shock
- Failure to wean from cardiopulmonary bypass
- Stabilization of patient prior to surgery
- Acute myocardial infarction/heart failure
- Advanced cardiomyopathy
- Ventricular arrhythmias
Assigning a code in ICD-10-PCS - 5A02210
From a coding perspective, the IABP is not classified as a device such as the VAD’s. The IABP is not coded as a device within ICD-10-PCS and is coded with the root operation of “Assistance.” The ICD-10-PCS code for insertion of an IABP for continuous pumping would be 5A02210, Extracorporeal or Systemic Assistance, Physiologic Systems, Assistance, Cardiac, Continuous, Output, Balloon Pump.
AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS, Second Quarter 2018 Pages: 3-5
AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS, Third Quarter 2017 Pages: 18-19
AHA Coding Clinic, First Quarter 2017 Page: 10-11
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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.
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