Cardiology Coding Alert

Question: Is 434.x the correct code for a postoperative cerebrovascular accident (CVA)?

Nebraska Subscriber

Answer: According to the ICD-9 official guidelines, the appropriate code for a postoperative CVA is 997.02  (Iatrogenic cerebrovascular infarction or hemorrhage) with a secondary code from cerebrovascular disease codes 430-432.x (subarachnoid, intracerebral, or other intracranial hemorrhage) -- or 433.xx-434.xx (artery occlusion) with a fifth digit of "1" -- to identify the type of hemorrhage or infarct.

Term tip: "Iatrogenic" means unintentionally induced by a physician through medical or diagnostic procedures. The guidelines instruct that "the medical record documentation must specifically identify the cause and effect relationship of the procedure and the CVA" (www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm).