AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 2; Ask the Editor

Carotid Artery Stenosis and Transient Ischemic Attack

A 73-year-old female presents due to intermittent episodes of balance and vision changes with right hemiparesis. She is diagnosed with transient ischemic attack (TIA) due to bilateral carotid artery stenosis, with left side symptomatic stenosis.  Left carotid endarterectomy with bovine patch angioplasty was performed. There is an Excludes 1 note under category I65-, Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction, that prohibits the reporting of a code from this category with the TIA code. The stroke team at our facility is concerned that if the TIA is not coded separately, their workup is not being captured.  Would it be appropriate to assign codes for both the TIA and bilateral carotid artery stenosis? ...

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