Cardiology Coding Alert

ICD-10:

Right, Left, Bilateral Options Expand Carotid Artery Stenosis Choices

433.10 leads to more choices.

When your cardiologist performs angiography, catheterization, or stent procedures in the carotid artery for conditions such as stenosis, you’ll need more information to accurately report the condition under ICD-10. 
 
You should be ready to implement these changes when ICD-10 goes into effect on Oct. 1, 2015.
 
ICD-9 offers two codes for carotid artery stenosis: 
  • 433.10 — Occlusion and stenosis of carotid artery without cerebral infarction
  • 433.11 — Occlusion and stenosis of carotid artery with cerebral infarction.
But each of these codes grows to four different code choices under ICD-10. That’s because the new code set accounts for whether the stenosis is in the right, left, unspecified, or bilateral carotid arteries.
If your cardiologist doesn’t specify the side, your direct crosswalk for 433.10 will be I65.29 (Occlusion and stenosis of unspecified carotid artery without cerebral infarction) under ICD-10. Your other code choices will be as follows, provided that your physicians provide adequate documentation:
  • I65.21 — Occlusion and stenosis of right carotid artery
  • I65.22 — Occlusion and stenosis of left carotid artery
  • I65.23 — Occlusion and stenosis of bilateral carotid arteries.