AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 2; Ask the Editor

Thromboendarterectomy with Deconstruction of Internal Carotid Artery

A patient with stenosis of the left cervical internal carotid artery (ICA) and left hemispheric embolic stroke underwent left-sided thromboendarterectomy. At surgery, an arteriotomy was started from the common carotid artery and extended up into the highest exposed portion of the ICA. A large fragment of thrombotic calcific plaque including intraluminal thrombus was removed. As the distal extent of this plaque material was followed within the ICA, there was no end that could be visualized, and there was no robust backbleeding. The surgeon felt that it would be too risky to reconstitute the antegrade flow. After allowing for backbleeding from the external carotid artery (ECA), the surgeon then deconstructed the proximal ICA, utilizing suture material. Clamps were removed from the common carotid and ECA, allowing for egress of flow from the common carotid to the external and superior thyroid artery. There was no flow into the ICA. What are the appropriate ICD-10- PCS codes for this procedure? ...

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