dx 442.89 for ICA aneurysm??


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Physician coded dx for this report 442.89. However, it was denied -- I'm unsure if there are any further dx to code for Evidence of recanalization of the right ICA aneurysm / Coiling of intracranial unruptured right cavernous ICA aneurysm..please assist. Thank you.

Examination: MRI of the brain without and with contrast.

Clinical History: Coiling of intracranial unruptured right cavernous ICA aneurysm

Technique: MRI of the brain was performed using diffusion and FLAIR imaging as well as an MRA using 3-D time-of-flight images before and after the administration of contrast. Reformats were also performed. Comparison is made with 7/29/2011.

Findings: Chronic microvascular ischemic changes in the periventricular, pontine and subcortical white matter are stable. Gliosis the right frontal approach catheter is stable. Ventricular size is unchanged.

Coil artifact is noted within the supraclinoid internal carotid artery aneurysm. Additionally, there is irregularity through the cavernouss egment of the right internal carotid artery which is most consistent with stent placement. The stent is patent. There is a curvilinear area of increased signal intensity which appears similar on pre-and-post contrast imaging along the medial aspect the cavernous internal carotid artery. Findings suggest flow within the aneurysm. However, the increased signal/enhancement is just along the medial aspect of the stent and there is a small chance this is artifact from the stent.

Evidence of recanalization of the right ICA aneurysm.