Question Right femorotibial occlusion

dballard2004

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What would be the correct ICD-10-CM code for right femorotibial occlusion, please? I am referencing the ICD-10-CM and ICD-10-PCS Coding Handbook, with Answers and this dx is listed in one of the examples for an inpatient admission.

Here is the scenario:

"A patient, who had peripheral vascular disease, came in for a second opinion about possible reconstruction of right femorotibial occlusive disease. An angiogram of the right lower extremity with low osmolar contrast demonstrated a peroneal vessel that would allow reconstruction. Following an evaluation, he was scheduled to undergo the procedure. However, because he had no other significant diseases or active cardiac ischemia, he was felt to be at low risk for a distal reconstruction. The patient was discharged prior to the procedure due to the development of an upper respiratory infection. The procedure was rescheduled for two weeks."



Discharge diagnoses: (1) Right femorotibial occlusion, (2) URI.

The book lists the correct ICD-10-CM codes as:

I74.3 (Embolism/thrombosis of arteries of the lower extremities)
J06.9 (URI, unspecified)
Z53.09 (Procedure not carried out because of other contraindication)

I agree with codes J06.9 and Z53.09, but how do you get I74.3 for the right femorotibial occlusion? We are having a debate with the coders about this. They think it should be code I70.201. Others say code I74.3 is correct.

Any insight would be appreciated. Thanks.
 

carelitz

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Based on ICD 10 data website, I would agree with I74.3. If you look under the code at the "Approximate Synonyms" it states, "Right femoral artery occlusion."

The I70.201 (Unspecified atherosclerosis) states chronic total occlusion. I believe you need to have that documented. A chronic total occlusion (CTO) is defined as the complete obstruction of a coronary artery, exhibiting TIMI 0 or TIMI 1 flow, with an occlusion duration of >3 months.

In any case I usually trust the approximate synonyms on ICD10Data.com.

(Reference Link: https://www.icd10data.com/ICD10CM/Codes/I00-I99/I70-I79/I74-/I74.3)
 
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fwnewbie

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When I read this, I'm missing the specification that this is a venous occlusion vs an arterial occlusion, which would make a difference in the coding.
 
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