A patient with a history of prosthetic femoral to popliteal bypass presents with occlusion of the bypass graft. An incision is made with dissection down to the subcutaneous tissue through muscle to identify the graft. The graft appeared to have collapsed near the proximal and distal ends at the anastomoses. The anastomotic areas were treated with balloon angioplasty followed by stent insertion in order to have outward radial force and prevent a complete redo femoral-popliteal bypass procedure. What is the correct ICD-10-PCS code for the angioplasty with stent insertion?
In this case, there was a problem with the graft rather than progression of disease. The previously placed graft had collapsed at both anastomoses, resulting in narrowing, requiring treatment with angioplasty and stenting. The surgeon indicated his objective was to correct the graft in hopes of preventing a new or "redo" femoral to popliteal bypass procedure. Surgery performed due to failure of the graft is coded as revision. Angioplasty and stent insertion to address progression of disease would be coded as dilation. If the documentation is not clear, query the provider, so that the appropriate code can be assigned. Assign the following ICD-10-PCS code:
04WY0JZ Revision of synthetic substitute in lower artery, open approach, for the angioplasty and stenting of the femoral-popliteal bypass graft
Revision is defined as correcting, to the extent possible, a portion of a malfunctioning device or the position of a displaced device.