Yes I am sure and aware of that the cerebro vascular diseases are separate entity from PVD. But due to the inclusion of Carotid artery in classification in coding, it was a misconception. I could not find this particular disease in the broad listing of the CVD. It was grouped up into PVd for in a particular instance as a deviation. Please forget about the misconception part of it .Let us come to the real point of the complexity of assigning the code.
I do agree that the ICD -9 by and large depicts the clarity.
Now , I tried to browse the classification of Cerebro Vascular Diseases at standard www. aan.com global –a neurologist guide for ICD Coding . which gives the whole lot of cerebrovascular Diseases Coding bit by bit. I got the whole list of the cerebrovascular diseases ;yet I did not find the terminology there.
But there is a group which specifies the pathophysiology prevalently occurring in Small Vessel disease, called Lacunar infarcts with parenchymal lesions (mainly Stroke related )which are better detected by the available methods( like MRI findings), than the changes in the vessels itself, which gets the code 434. 91- cerebral artery, unspecified.
See if this could help us to have a better understanding about this elaborate group of diseases:
[ The term cerebral small vessel disease refers to a group of pathological processes with various aetiologies that affect the small arteries, arterioles, venules, and capillaries of the brain. Age-related and hypertension-related small vessel diseases and cerebral amyloid angiopathy are the most common forms. The consequences of small vessel disease on the brain parenchyma are mainly lesions located in the subcortical structures such as lacunar infarcts, white matter lesions, large haemorrhages, and microbleeds. Because lacunar infarcts and white matter lesions are easily detected by neuroimaging, whereas small vessels are not, the term small vessel disease is frequently used to describe the parenchyma lesions rather than the underlying small vessel alterations. This classification, however, restricts the definition of small vessel disease to ischaemic lesions and might be misleading. Small vessel disease has an important role in cerebrovascular disease and is a leading cause of cognitive decline and functional loss in the elderly. Small vessel disease should be a main target for preventive and treatment strategies, but all types of presentation and complications should be taken into account].
So, could we agree with this code assignment434.91 by and large?
Thank you for your time and patience.