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Thread: Dx code for Coronary Stent restenosis?

  1. #1

    Default Dx code for Coronary Stent restenosis?

    AAPC: Back to School
    I am new to cardiology coding. Dictation states mid stent with focal 95% in-stent restenosis. Would the correct dx code be 996.74? Any help is most appreciated, thank you.

  2. #2


    Quote Originally Posted by FLSJarrel View Post
    I am new to cardiology coding. Dictation states mid stent with focal 95% in-stent restenosis. Would the correct dx code be 996.74? Any help is most appreciated, thank you.

    There are different opinions on this. There appears to be some logic behind reporting dx 996.72 which is what some say is correct to report, there seems to be more logic to not classify this as a "complication" due to the stent. SOme patients continue to have build up throughout their arteries whether a stent was placed or not and it is not as if the stent malfunctioned in any way.

    I would report in stent restenosis as CAD of the type of vessel in which the stent was placed. If it took place in a native vessel I would use 414.01 and so on.

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado

    Thumbs up Thank you!

    Thank you both for this post. I am also somewhat new to cardiovascular coding, as I recently took a new job where they have asked me to do coding for Cardiology and Vascular surgeons (not my "specialties" but I am the more seasoned coder at my new employer). I have not coded this scenario so far as a complication of the stent...tend to agree with the 2nd opinion, and what Theresa stated. That helps me feel more confident in what I am doing!
    Lisa Bledsoe, CPC, CPMA

  4. #4


    I appreciate the clarification. I was very hesitant about my choice & what you said makes more sense. Thanks.

  5. #5

    Default which code would be correct for the ccc test?

    I have always used the 41401(etc) as suggested, but in studying for my ccc the aapc study guide states to use the 99674. What would be correct to use on the test? :/

  6. #6
    Join Date
    Apr 2007

    Default CCC Study Guide

    I also see 996.74 in the CCC Study Guide. Page 10 of the 2013 study guide states "For stenosis of previously stented coronary artery, assign 996.74."

  7. #7


    If you look under code 996.72 the TIP says "assign for in-stent stenosis of previously placed coronary artery stent."

  8. #8
    Join Date
    Apr 2007
    Glendale Geckoders


    I just seen the above thread and would like to add one thing Per Optum Coders' Desk Reference for Diagnoses for 2013 If you use code 996.42 you should use an additional code to identify the reason for the complication. Therefore the code 996.72 would be used as well as 414.XX.

    Hope this helps.
    The Eagle
    Glendale AZ Chapter

  9. #9
    Join Date
    Apr 2007

    Default 996.74

    In addition to my previous post I'd like to point out that the 996.7X series of diagnosis codes state "other complications of...". If you look at the 996.6X series of codes you'll see "infection or inflammatory reaction due to..." and if you look at the 996.0X series of codes you'll see "Mechanical complication of..." Because 996.74 falls under the "other complications" I feel that it is appropriate to code the 996.74 for in-stent restenosis. You will want to additionally code the coronary artery disease as well (ie; 414.01). One other thing. 996.72 is for "other cardiac device, implant of graph" 996.74 is for "vascular device, implant or graft". The coronary arteries are considered vascular.

    Jenn Haney, CPC, CCC
    Last edited by MacksMom; 11-26-2013 at 09:46 AM. Reason: Additional Info Added

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