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Thread: 414.00 vs 414.01

  1. #1

    Default 414.00 vs 414.01

    I am new to the cardiology scene and I have a question for the experts.

    What code would you use for Coronary Artery Disease?

    I am using 414.00 and the MD is using 414.01

    Any help is greatly appreciated

    Thanks,
    Dawn
    Dawn Smith, CPC
    [email]dsmith28@iuhealth.org

  2. #2
    Join Date
    Apr 2007
    Location
    York, Pa
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    1,901

    Default

    Quote Originally Posted by dawn1170 View Post
    I am new to the cardiology scene and I have a question for the experts.

    What code would you use for Coronary Artery Disease?

    I am using 414.00 and the MD is using 414.01

    Any help is greatly appreciated

    Thanks,
    Dawn
    Have you reviewed the narrative in both codes, what does his documentation state. Does it clearly state Native coronary artery or is he being non-specific and just saying CAD...

    I would check his documentation carefully, the dx he is using is very specific and the one your using is unspecified.

    Just a thought
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  3. #3

    Default 414.00 vs 414.01

    The MD only states CAD.

    The MD is using the 414.01 on all of his CAD charts. There is nothing mentioned about native artery however; In the AHA coding clinic it states that if there is no history of a Graft being performed than 414.01 is to be used. I am soooo confused.

    Thanks
    Dawn
    Dawn Smith, CPC
    [email]dsmith28@iuhealth.org

  4. #4
    Join Date
    Apr 2007
    Location
    Jacksonville, Florida - 90417
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    Default 414.00 vs 414.01

    Hi Dawn,

    Native coronary arteries are those that the patient was born with - before any bypasses were performed with veins or arteries from other areas of the body.

    Per AHIMA's Coding Clinic:
    Assign code 414.00 if the documentation does not identify the coronary artery involved. Code 414.01 is assigned if the documentation specifies that the CAD is of a native coronary artery or if there is no history of a previous coronary artery bypass graft (CABG). Code 414.02 is assigned if the documentation indicates CAD of a bypass graft using the patients own vein and code 414.03 is assigned when the graft is not of the patient's own tissue. Code 414.04 is assigned when the CAD involves an artery (mammary, brachial, etc) used as a bypass graft. Code 414.05 is assigned when the CAD is of a bypass graft but the type of bypass graft is not identified. It is incorrect to assign a code from range 414.02-414.05, merely because a patient has had previous coronary artery bypass surgery. Query the physician if the documentation in the medical record is unclear as to which artery is involved.

    Hope this helps.

    -Maryann C. Palmeter, CPC

  5. #5
    Join Date
    Apr 2007
    Location
    York, Pa
    Posts
    1,901

    Default

    Quote Originally Posted by dawn1170 View Post
    I am new to the cardiology scene and I have a question for the experts.

    What code would you use for Coronary Artery Disease?

    I am using 414.00 and the MD is using 414.01

    Any help is greatly appreciated

    Thanks,
    Dawn
    Hello Dawn,

    I was on another coding website and saw this link, see what you think about it...

    http://www.coderyte.com/resources/co...y-disease.html


    I found it very interesting.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  6. #6
    Join Date
    Apr 2007
    Location
    Moore, OK
    Posts
    47

    Default

    This is a very helpful string. The links and other information provided was excellent; very useful. Thanks to all involved.

  7. #7

    Default 414.00 vs. 414.01

    Coding Clinical originally addressed this topic in 1995; however they published further clarification in Third Quarter 1997 Coding Clinic which indicates that for a diagnosis of coronary artery disease, when there is no documentation of prior CABG, the appropriate code selection would be 414.01. The assumption is that the vessel is native, unless specifically stated that there was are also graft vessels present.

    Linda Templeton, CCS-P, CPC, CPC-H

  8. #8

    Default

    I also use 414.01, even if it is not specified. The way it was explained to me was that the patient always have CAD in their native artery. If they had a bypass the CAD was not removed, it was just bypassed.

  9. #9

    Default 414.00 vs 414.01

    Thank you all for all the information and feedback.
    Dawn Smith, CPC
    [email]dsmith28@iuhealth.org

  10. #10

    Default Cad

    If the documentation just says "coronary artery disease", then you should use the unspecified code 414.00. You would only use 414.01 if the documentation clearly states that it is CAD of a native artery (i.e. "80% stenosis of the LAD", etc.). I would caution anyone about "assuming" that the CAD is of a native artery.

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