Wiki Carotid artery syndrome g45.1

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Code: G45.9
Transient cerebral ischemic attack, unspecified
Spasm of cerebral artery
TIA
Transient cerebral ischemia NOS
Parent Code Notes: G45
Excludes1: neonatal cerebral ischemia (P91.0)
transient retinal artery occlusion (H34.0-)

Category Notes
Episodic and paroxysmal disorders (G40-G47)

Coding Guidelines
Diseases of the nervous system (G00-G99)
Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

trichards139

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Can anyone tell me when it is appropriate to use this code? It is under TIA and related syndromes, so can this be used when someone has carotid artery stenosis and they are having TIA symptoms?
 
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Can anyone tell me when it is appropriate to use this code? It is under TIA and related syndromes, so can this be used when someone has carotid artery stenosis and they are having TIA symptoms?

Assuming this is outpatient, you can only code confirmed diagnoses. If the documentation states the patient is having "TIA symptoms" then you'd code for the symptoms until a final diagnosis has been made. Sometimes symptoms are part of an already established diagnosis, sometimes not.

It's nearly impossible to give you a yes or no answer based off what you've posted. It's really all dependent on what the provider has documented. Can you provide the specific language the provider used?
 

trichards139

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G45.1

This was an inpatient consult. We saw pt for "TIA with carotid stenosis". The impression is: 1) TIA 2) Previous cerebrovascular accidents 3) Known right internal carotid artery occlusion s/p rt carotid surgery
The patient was off Coumadin in preparation for colonoscopy. I just found this code when looking up TIA, G45.9, and since trying to get away from using unspecified codes I happened to see the code for carotid artery syndrome and wondered what that was. I have not had the opportunity to ask one of my cardiovascular surgeons.
 
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This was an inpatient consult. We saw pt for "TIA with carotid stenosis". The impression is: 1) TIA 2) Previous cerebrovascular accidents 3) Known right internal carotid artery occlusion s/p rt carotid surgery
The patient was off Coumadin in preparation for colonoscopy. I just found this code when looking up TIA, G45.9, and since trying to get away from using unspecified codes I happened to see the code for carotid artery syndrome and wondered what that was. I have not had the opportunity to ask one of my cardiovascular surgeons.

Since this was an inpatient consultation, you can't code for suspected diagnosis (or impressions) unless they have not been ruled out at the time of discharge. So from the info provided, clearly they think the pt had a TIA, but nothing reads to me that would indicate a solid diagnosis for that. (Excluding the previous HX piece) The only condition/symptom/problem that is clear and confirmed is the known occlusion. If the TIA was confirmed, then the code for the occlusion gets removed, if I understand the guidelines correctly.

If it were me, I think I'd lean towards I65.21 Occlusion and stenosis of right carotid artery until the TIA is confirmed. I'd also tack on a "history of" code with the I65.21, because it's mentioned specifically AND it's potentially relevant to the situation.

I don't know if that helps at all, but that's my two cents anyhow.
 
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