In code Table 02F, Fragmentation of Heart and Great Vessels, body part values for coronary artery(ies) as noted below were added to identify coronary intravascular lithotripsy.
|0 Coronary Artery, One Artery
1 Coronary Artery, Two Arteries
2 Coronary Artery, Three Arteries
3 Coronary Artery, Four or More Arteries
|3 Percutaneous||Z No Device||Z No Qualifier|
Coronary intravascular lithotripsy (IVL) is a new treatment that utilizes controlled sound waves in short pulses to selectively crack intimal and medial calcium within coronary artery(ies) without affecting soft tissue. Once fractured, the calcium’s resistance to balloon dilatation is reduced, thereby allowing the blood vessel to be dilated using a low-pressure angioplasty balloon prior to coronary stenting. Separate ICD-10-PCS code(s) are assigned for angioplasty or stent insertion if performed.
The procedure is performed using multiple lithotripsy emitters that are integrated into a semi-compliant balloon-catheter platform. The coronary IVL catheter is advanced to the target lesion and the integrated balloon is inflated with fluid at a low pressure to contact the arterial wall. Coronary IVL is activated, creating a small bubble within the catheter balloon that rapidly expands and collapses. Sonic pressure waves are created that travel through the innermost layer of the vessel wall to crack the calcified lesions within the vessel wall.