Coronary artery bypass graft

Esylvester

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Hello,
I am currently going to school to be a coder and biller. On my lastest exam I have a question that is " A patient with servere arteriosclerotic heart disease of native arteries and servere COPD was admitted for coronary artery bypass graft X 4 with cardiopulmonary bypass. Postoperatively, the patient developed pulmonary emboli that required treatment and extened the inpatient stay. Code this with POA indicator."
So far I have 414.01-Y for the ASHD and 496-Y for COPD. I have looked everywhere in my ICD-9 book and I can't seem to find a code for CABG. Can someone please tell my if I am coding this correctly and how to code CABG?
Thank you!
 

kml1764

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I am also a student, but I believe that you need to look in the CPT Code book. It is a procedure done by a surgeon. Codes 33510 - 33548 cover CABG. You'd want to see what vessel(s) are being grafted. It can be venous, a combined arterial-venous, or arterial.
 

Esylvester

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Thank you very much. I didn't even think to look in CPT, I just assumed it would be in ICD-9 since all my other codes on my exam where. I will definitely look in CPT.
 

mitchellde

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This question looks as if it is from the facility perspective not the physician, the facility inpatient would never use a CPT code. the question is asking for POA indicator. If you need help on POA go to the ICD-9 coding guidelines and at the back is an entire section for POA (Present on Admission), this is not something that would ever be applicable to the physician coder only the inpatient facility coder. You should probably code for the emboli which was the cause for the extension of the encounter, for DRG purposes. The CABG will be coded with ICD-9 vol 3 codes for the facility.
 
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