AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 4; New/Revised ICD-10-CM Codes
Intravascular Lithotripsy
Intravascular lithotripsy is used alone or with stent placement to treat plaque in the arteries. Shockwave lithotripsy is a new technology that uses a traditional balloon catheter with multiple mounted emitters to provide pulsatile sonic energy to fragment calcified calcifications within the vessels. The procedure is performed by delivering an intravascular lithotripsy (IVL) catheter across a calcified lesion over a wire and the integrated balloon is expanded. An electrical discharge from the emitters vaporizes the fluid within the balloon, creating a rapidly expanding and collapsing bubble that generates sonic pressure waves. The waves travel through soft vascular tissue, selectively...
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Article Overview
This article provides a high-level overview of intravascular lithotripsy in the treatment of calcified arterial plaque and then applies that topic to a coding-focused angioplasty scenario. It is aimed at readers who need to understand the procedure context, the vascular anatomy involved, and how the case is represented in ICD-10-PCS for facility coding purposes. The article also touches on the relationship between shockwave lithotripsy therapy and drug-coated balloon angioplasty in an arterial intervention setting.
Why This Topic Matters
Intravascular lithotripsy is a newer vascular technology, so coders and clinical documentation staff need to understand how procedure details and anatomy affect coding. The article helps readers identify when a case involves treatment of calcified lesions, balloon-based intervention, and related ICD-10-PCS assignment considerations.
What You Will Learn
- What intravascular lithotripsy is used for in arterial procedures
- How shockwave-based vascular therapy is described in a procedural context
- How an angioplasty case involving the external iliac and common femoral arteries is presented for coding review
- What ICD-10-PCS coding is being discussed for this type of vascular intervention
Who Should Read This
- Inpatient coders
- Facility coding professionals
- Clinical documentation specialists
- Revenue cycle staff
- Vascular surgery coding teams
Codes Discussed
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