AHA Coding Clinic® for ICD-9 - 2007 Issue 1; Ask the Editor
Biventricular Defibrillator Insertion with Angioplasty
The patient is an 83-year-old female who has acute on chronic congestive heart failure with an ejection fraction of about 20% and ischemic cardiomyopathy. The patient was admitted and underwent implantation of cardiac resynchronization defibrillator (CRT-D) total system (device and leads). During the insertion of the CRT-D, coronary angioplasty of the lateral branch and left coronary sinus angiogram were also performed. Our coders are unsure if the angioplasty and angiography are considered integral to the CRT-D implantation or if separate ICD-9-CM procedure codes should be assigned. What are the appropriate procedure code assignments? ...
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Article Overview
This premium coding article reviews a cardiac procedure case involving device implantation with additional coronary work performed during the same encounter. It is intended for coders and billing staff who need to understand the scope of the procedure, the code set involved, and the article’s guidance on whether separate procedure reporting is being considered. The content is focused on procedure coding questions for an inpatient cardiovascular case and discusses the coding framework relevant to the services described.
Why This Topic Matters
Cardiovascular procedure coding often depends on whether additional services are considered part of the primary operation or separately reportable. This article helps readers evaluate a specific CRT-D implantation scenario in the context of procedure code assignment.
What You Will Learn
- How the article frames a cardiac device implantation case with concurrent coronary intervention
- What coding issue is being evaluated for the same operative encounter
- Which procedure coding framework the article references for this scenario
- How the article situates the question of separate reporting for associated services
Who Should Read This
- Medical coders
- Inpatient coding professionals
- Billing staff
- Revenue cycle professionals
- Clinical documentation specialists
Codes Discussed
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