Cardiology Coding Alert

Hint: Report I71.12 for a ruptured aneurysm of the aortic arch.

If your practice performs vascular surgery, you must be aware of the different diagnosis codes available for aortic aneurysms. Not only do you need to know the exact anatomic site of the aortic aneurysm, but also whether the site has ruptured.

Review the answers to these seven tough questions to help you choose the correct diagnosis code for every case.

Aorta Dilated With Aortic Aneurysm

Question 1: What is an aortic aneurysm?

Answer 1: An aortic aneurysm is an enlargement, or dilatation, of the aorta to 1.5 times its normal size. This dilation causes the wall of the artery to weaken and can eventually rupture which can be life-threatening.

An aortic aneurysm occurs in the aorta—the main blood vessel leading from the heart to the abdomen, pelvis, and legs.

There are three types of aortic aneurysms, and they are based on their location on the aorta: thoracic, abdominal, and thoracoabdominal, says Catherine Brink, BS, CPC, CMM, president of Healthcare Resource Management in Spring Lake, New Jersey.

I71- (Aortic aneurysm and dissection) is the ICD-10-CM category for aortic aneurysms, Brink adds. The specific codes depend on location and rupture.

It is also important to note that category I71- has code first guidelines for syphilitic aortic aneurysm (A52.01) and traumatic aortic aneurysm (S25.09 and S35.09), if applicable, says Carol Hodge, CPC, CPMA, CDEO, CCC, CEMC, CPB, CFPC, COBGC, senior documentation specialist at St. Joseph’s/Candler Medical Group.

Lean on These Options for Thoracic Aortic Aneurysms

Question 2: What codes should I report for thoracic aortic aneurysms?

Answer 2: Report the following ICD-10-CM codes for thoracic aortic aneurysms:

• I71.10 (Thoracic aortic aneurysm, ruptured, unspecified)
• I71.11 (Aneurysm of the ascending aorta, ruptured)
• I71.12 (Aneurysm of the aortic arch, ruptured)
• I71.13 (Aneurysm of the descending thoracic aorta, ruptured)
• I71.20 (Thoracic aortic aneurysm, without rupture, unspecified)
• I71.21 (Aneurysm of the ascending aorta, without rupture)
• I71.22 (Aneurysm of the aortic arch, without rupture)
• I71.23 (Aneurysm of the descending thoracic aorta, without rupture)

Report Abdominal Aortic Aneurysms This Way

Question 3: Which codes should I report for abdominal aortic aneurysms?

Answer 3: Report the following ICD-10-CM codes for abdominal aortic aneurysms:

• I71.30 (Abdominal aortic aneurysm, ruptured, unspecified)
• I71.31 (Pararenal abdominal aortic aneurysm, ruptured)
• I71.32 (Juxtarenal abdominal aortic aneurysm, ruptured)
• I71.33 (Infrarenal abdominal aortic aneurysm, ruptured)
• I71.40 (Abdominal aortic aneurysm, without rupture, unspecified)
• I74.41 (Pararenal abdominal aortic aneurysm, without rupture)
• I74.42 (Juxtarenal abdominal aortic aneurysm, without rupture)
• I71.43 (Infrarenal abdominal aortic aneurysm, without rupture)

Look to These Codes for Thoracoabdominal Aortic Aneurysms

Question 4: Which codes can I report for thoracoabdominal aortic aneurysms?

Answer 4: Report the following ICD-10-CM codes for thoracoabdominal aortic aneurysms:

• I71.50 (Thoracoabdominal aortic aneurysm, ruptured, unspecified)
• I71.51 (Supraceliac aneurysm of the thoracoabdominal aorta, ruptured)
• I71.52 (Paravisceral aneurysm of the thoracoabdominal aorta, ruptured)
• I71.60 (Thoracoabdominal aortic aneurysm, without rupture, unspecified)
• I71.61 (Supraceliac aneurysm of the thoracoabdominal aorta, without rupture)
• I71.62 (Paravisceral aneurysm of the thoracoabdominal aorta, without rupture)

Don’t Despair When You See “Unspecified”

Question 5: How should we handle cases where the aortic aneurysm is unspecified?

Answer 5: If you have an aortic aneurysm of an unspecified site that is ruptured, report I71.8 (Aortic aneurysm of unspecified site, ruptured). This code also includes rupture of aorta NOS.

On the other hand, if you have an aortic aneurysm of an unspecified site without rupture, report I71.9 (Aortic aneurysm of unspecified site, without rupture). This code also includes aneurysm of aorta, dilatation of aorta, and hyaline necrosis of aorta.

Carefully Mind 5th Character

Question 6: What does the 5th character tell you in the ICD-10-CM codes for abdominal aortic aneurysm?

Answer 6: The 5th character provides more detail about the anatomic site of the aneurysm. For example, the 5th character tells you the following anatomic for the thoracic codes.

1 Ascending aorta
2 Aortic arch
3 Descending thoracic aorta

For the abdominal aortic aneurysm codes, the 5th character identifies the following anatomic locations:

1 Pararenal
2 Juxtarenal
3 Infrarenal

For thoracoabdominal aortic aneurysm codes, the 5th character identifies the following anatomic locations:

1 Supraceliac
2 Paravisceral

Identify Whether Rupture or No Rupture

Question 7: Why is it important to know whether the aneurysm is ruptured or without rupture?

Answer 7: The aortic aneurysm codes are categorized by whether a rupture occurred, so you must know this information to choose the appropriate code.

For example, codes I71.10 through I71.13, I71.30 through I71.33, and I71.50 through I71.52 will offer more specificity when the patient has a ruptured aortic aneurysm.

On the other hand, codes I71.20 through I71.23, I71.40 through I71.43, and I71.60 through I71.62 offer more specificity when the patient has an aortic aneurysm without a rupture.