Cardiology Coding Alert

Question: Would you break down the ICD-9 codes I'm most likely to use for aortic aneurysms?

Connecticut Subscriber

Answer: Aneurysms are common in two sections of the aorta, the major artery leading away from the heart. You'll need to know the aneurysm's location and condition to assign the proper ICD-9 codes:

Abdominal aortic aneurysm (AAA) -- Occurring in the abdominal region, use 441.3 (Aortic aneurysm and dissection; abdominal aneurysm, ruptured) or 441.4 (... abdominal aneurysm without mention of rupture) to report the condition with or without rupture.

Thoracic aortic aneurysm (TAA) -- Occurring in the thoracic region, report TAA as 441.1 (... thoracic aneurysm, ruptured) or 441.2 (... thoracic aneurysm without mention of rupture) depending on whether a rupture is present.

For an aneurysm between the two regions, report 441.6 (... thoracoabdominal aneurysm, ruptured) or 441.7 (... thoracoabdominal aneurysm, without mention of rupture), depending on rupture status. For an unspecified site, use 441.5 (... aortic aneurysm of unspecified site, ruptured) or 441.9 (... aortic aneurysm of unspecified site without mention of rupture).

Tip: The diaphragm is the dividing line between the thorax and abdomen, so the thoracic aorta leaves the heart and arches, and descends through the chest until it reaches the diaphragm. The aorta becomes the abdominal aorta after it passes the diaphragm and continues down the abdomen.

Definition: When a blood vessel wall weakens, an abnormal vessel ballooning or widening, called an aneurysm, can result. If an aneurysm ruptures, it can lead to massive bleeding and death.

The physician may also diagnose the patient with the related condition, aortic dissection, which occurs when blood enters through a tear in the aorta's lining into the space between the vessel's middle and outer layers, causing a separation. This can occur in the abdominal or thoracic aorta, and you'll assign the proper code (441.0x, Dissection of aorta ...) based on the site.

Good advice: Using diagnosis coding tools can shorten your work time, but you should always check your manual to be sure you've chosen the most accurate code.