Wiki icd 9

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
G
Code: I65.23

Code Name: ICD-10 Code for Occlusion and stenosis of bilateral carotid arteries

Block: Cerebrovascular diseases (I60-I69)

Excludes 1: transient cerebral ischemic attacks and related syndromes (G45.-)
traumatic intracranial hemorrhage (S06.-)

Use additional code to identify presence of:alcohol abuse and dependence (F10.-)
exposure to environmental tobacco smoke (Z77.22)
history of tobacco use (Z87.891)
hypertension (I10-I15)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)

Details: Occlusion and stenosis of bilateral carotid arteries

I65

Includes: embolism of precerebral artery
narrowing of precerebral artery
obstruction (complete) (partial) of precerebral artery
thrombosis of precerebral artery

Excludes1: insufficiency, NOS, of precerebral artery (G45.-)
insufficiency of precerebral arteries causing cerebral infarction (I63.0-I63.2)

Guidelines: Diseases of the circulatory system (I00-I99)

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)
systemic connective tissue disorders (M30-M36)
transient cerebral ischemic attacks and related syndromes (G45.-)

For more details on I65.23 , ICD-10 Code for Occlusion and stenosis of bilateral carotid arteries visit: https://coder.aapc.com/icd-10-codes/

twills77

Guest
Messages
4
Best answers
0
Carotid artery disease

How would you get to 433.10 using the alpha index for carotid artery disease? We need to code it for reimbursement but if provider doesn't say stenosis or occlusion, how do you get to 433.10? Thank you.
 

Coder_Rick

Networker
Messages
45
Best answers
0
you go to Stenosis

If you go to Stenosis, then artery / carotid you'll be referred to 'see narrowing, artery, carotid' go there, and you'll find carotid 433.1x

433.10 is for when the documentation states with occlusion or stenosis

Without stenosis documented, you go to Disease, arterial, go down to specified type which is 447.8 'other specified disorders of arteries and arterioles'.

Hope that helps!
 

millortsui

Networker
Messages
67
Best answers
0
If you go to Stenosis, then artery / carotid you'll be referred to 'see narrowing, artery, carotid' go there, and you'll find carotid 433.1x

433.10 is for when the documentation states with occlusion or stenosis

Without stenosis documented, you go to Disease, arterial, go down to specified type which is 447.8 'other specified disorders of arteries and arterioles'.

Hope that helps!
447.8 is for fibromuscular hyperplasia of arteries, except renal. Since the code is not referring to fibromuscular hyperplasia. The better code 447.9 should be chosen as no specific description is present.
 

jessv1910

Networker
Messages
75
Best answers
0
Why would this be coded 433.10 without stenosis or occlusion being documented? Is there a coding clinic explaining this? Anybody? - I agree with code 477.9 and not 477.8. I believe 477.8 is for "other specified disorders" rather than "other specified arteries"
 

jessv1910

Networker
Messages
75
Best answers
0
Why would this be coded 433.10 without stenosis or occlusion being documented? Is there a coding clinic explaining this? Anybody? - I agree with code 477.9 and not 477.8. I believe 477.8 is for "other specified disorders" rather than "other specified arteries"
 

m.edwards

Networker
Messages
33
Location
Dekalb, Illinois
Best answers
0
Carotid artery disease is caused by build up of plaque over time within the carotid artery. This causes the carotid artery to become stiff and narrow. Stenosis is the abnormal narrowing or constriction of a passageway or opening (could be of a blood vessel or a tubular organ/structure).

Carotid artery disease is the same thing as carotid arterial stenosis. The narrowing or the carotid artery.

By coding carotid artery disease to 433.10, it encompasses both the symptomatic or asymptomatic disease and could represent either an embolism, narrowing, obstruction, or thrombosis within this artery, but does not need to represent all of those conditions at once. The description of the code within the ICD-9-CM clearly shows that it includes any of those terms. So in referring to carotid artery disease as the narrowing of the carotid artery, this is clearly within the code definition of 433.10.

Please also note as a comparison...when coding coronary artery disease, 414.00-414.07, here it is actually representing coronary atherosclerosis (hardening of the coronary artery), and is looked up in the alpha index under "atherosclerosis" and not "disease" (although looking under "disease" will tell you to look under "atherosclerosis"). Sometimes you have to look up a code using a different main term than you might first think, i.e. Narrowing or Stenosis instead of Disease for carotid artery disease.

Also, if you still choose to use other codes such as the 447.8 or 447.9, you should fully understand the difference between the two. 447.8 is technically arterial disease NEC (not elsewhere classified) while 447.9 is arterial disease NOS (not otherwise specified). Since the disease is specified, 447.8 is a better option. The "fibromuscular hyperplasia of arteries, except renal" that is mentioned under code 447.8 is there because it is a condition that is included within the scope/definition of the code, but that does not mean that the code is limited to only that disease or condition. Arteriectasis, acquired deformity of artery, Dego's Disease/Syndrome, etc. all code to 447.8.
 
Last edited:
Top