Atherosclerosis of the extremities is divided into three categories: native arteries, bypass grafts, and chronic total occlusion. It is caused by plaque buildup in the artery wall, which causes the artery to lose elasticity over time and can lead to complications like pain and gangrene. Coders must have documentation specifying atherosclerosis and use the appropriate ICD-9 and ICD-10 codes depending on location and severity.
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3 Categories of Atherosclerosis of Extremities in ICD-9/10 Coding
1. Atherosclerosis of the extremities (Monckebergâs Sclerosis)
is a peripheral vascular disease (PVD) that occurs in the arteries of
extremities; which is why it is sometimes referred to as peripheral
artery disease (PAD). The coder however, must have the
physicianâs documentation indicating the PAD is due to
atherosclerosis to ensure correct code assignment (see note). PAD
due to atherosclerosis is caused by plague made up of deposits of
fatty substances, cholesterol, cellular waste products, calcium,
and fibrin built up inside the artery wall. The artery loses its
elasticity due to the blockage which gradually develops into
complications such as rest pain, intermittent claudication,
ulcerations, and even gangrene.
NOTE: Peripheral Arterial Disease not specified as atherosclerotic
is coded to 443.9, Peripheral Vascular Disease, Unspecified in ICD-
9 CM and I73.9, Peripheral Vascular Disease, Unspecified in ICD-10
CM.
WHAT IS ATHEROSCLEROSIS OF THE EXTREMITIES?
WHAT TO EXPECT
1 What is Atherosclerosis of
the Extremities?
2 Atherosclerosis of Native
Arteries of the Extremities
3 Atherosclerosis of Bypass
Graft of Extremities & Total
Occlusion
4 Requests for Coding Topics
âPhysicianâs
documentation must
indicate
atherosclerosis.â
July 2014
Volume 1 Issue 7
By Cynthia Brown, MBA, RHIT, CCS
www.cyntcodinghealthinformationservices.com
CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984
http://www.cyntcodinghealthinformationservices.com
Cynthia@cyntcodinghealthinformationservices.com [phone]
CODING YESTERDAYâS NOMENCLATURE TODAYÂź
Coding Atherosclerosis of the Extremities
in ICD-9 CM & ICD-10 CM
CODING NEWSLETTER FOR HEALTHCARE
CODING PROFESSIONALS
2. Page 2 Coding Yesterdayâs Nomenclature Today
In ICD-9 CM and ICD-10 CM the codes for atherosclerosis of
the extremities are divided into three categories 1) of native
arteries of the extremities; 2) of bypass graft of extremities; and
3) chronic total occlusion of artery of the extremities.
NATIVE ARTERIES: Use additional code, if applicable to identify
chronic total occlusion of artery of the extremities in both ICD-9
CM (440.4) and ICD-10 CM (I70.92) throughout the subcategory.
ICD-9 CM: 440.20 Atherosclerosis of the extremities (AOE),
unspecified
ICD-10 CM: I70.201-I70.209 (The extremity is specified in ICD-10)
ICD-9 CM: 440.21 AOE with intermittent claudication
ICD-10 CM: I70.211-I70.219
ICD-9 CM: 440.22 AOE with rest pain
ICD-10 CM: I70.221-I70.229
ICD-9 CM: 440.23 AOE with ulceration (Use additional code for
associated ulceration (707.10-707.19, 707.8, 707.9)
ICD-10 CM: I70.231-I70.239 (Use additional code to identify
severity of ulcer, L97. - with 5th
character 1) OR I70.241-I70.249
(Use additional code to identify severity of ulcer, L97. - with 5th
character 2) OR I70.25 (Use additional code to identify severity of
ulcer, L98.49-)
ICD-9 CM: 440.24 AOE with gangrene (Use additional code for any
associated ulceration (707.10-707.19, 707.8, 707.9)
ICD-10 CM: I70.261-I70.269 (Use additional code to identify
severity of ulcer, L98.49-, IF APPLICABLE)
ICD-9 CM: 440.29 Other
ICD-10 CM: I70.291-I70.299
REMEMBER IN ICD-10 CM CODES THERE IS A DISTINCTION BETWEEN
RIGHT AND LEFT EXTREMITY, BILATERAL, OTHER AND UNSPECIFIED
EXTREMITY WHICH IS NOT FOUND IN ICD-9 CM CODES.
www.cyntcodinghealthinformationservices.com
âArterial/Venous Circulation
in Legsâ
âAtherosclerosis of
extremities divided into
3 categories.â
ICD-9 CM and ICD-10 CM CODES
3. Coding Yesterdayâs Nomenclature Today
ICD-9 CM and ICD-10 CM CODES
Bypass Graft of Extremities:
ICD-9 CM: 440.30 of unspecified graft
ICD-10 CM: I70.301-I70.309 OR I70.311-I70.319 OR I70.321-I70.329 OR
I70.331-339 OR I70.341-I70.349 OR I70.35 OR I70.361-I70.369 OR I70.391-
I70.399 *This subcategory requires the coder to use an additional code, if
applicable for chronic total occlusion of artery of extremity (I70.92); NOT
REQUIRED IN ICD-9 CM. This subcategory includes the complications of
the atherosclerosis such as rest pain, intermittent claudication, etc; NOT
SEEN IN ICD-9 CM. The coder must follow the instructional note for each
complication as described previously.
ICD-9 CM: 440.31 of Autologous vein bypass graft
ICD-10 CM: I70.401-I70.409 OR I70.411-I70.419 OR I70.421-I70.429 OR
I70.431-439 OR I70.441-I70.449 OR I70.45 OR I70.461-I70.469 OR I70.491-
I70.499 *This subcategory requires the coder to use an additional code, if
applicable for chronic total occlusion of artery of extremity (I70.92); NOT
REQUIRED IN ICD-9 CM. This subcategory includes the complications of
the atherosclerosis such as rest pain, intermittent claudication, etc; NOT
SEEN IN ICD-9 CM. The coder must follow the instructional note for each
complication as described previously.
ICD-9 CM: 440.32 of Nonautologous biological bypass graft
ICD-10 CM: I70.501-I70.509 OR I70.511-I70.519 OR I70.521-I70.529 OR
I70.531-539 OR I70.541-I70.549 OR I70.55 OR I70.561-I70.569 OR I70.591-
I70.599 *This subcategory requires the coder to use an additional code, if
applicable for chronic total occlusion of artery of extremity (I70.92); NOT
REQUIRED IN ICD-9 CM. This subcategory includes the complications of
the atherosclerosis such as rest pain, intermittent claudication, etc; NOT
SEEN IN ICD-9 CM. The coder must follow the instructional note for each
complication as described previously.
NOTE: ICD-10 CM added a subcategory (I70.601-I70.699) nonbiological
bypass graft(s) of the extremities and subcategory (I70.701-I70.799)
other type of bypass graft(s) that IS NOT found in ICD-9 CM. The coder
should follow the same instructional notes as in the other subcategories.
ICD-9 CM: 440.4 chronic total occlusion of artery of the extremities
(Code 1st
atherosclerosis of arteries of the extremities (440.20-440.29,
440.30-440.32)
ICD-10 CM: I70.92 chronic total occlusion of artery of the extremities
(Code 1st
atherosclerosis of arteries of the extremities (I70.2-, I70.3-,
I70.4-, I70.5-, I70.6-, I70.7-)
AHIMA approved ICD-10 CM/PCS
Trainer
ALL THINGS CODINGÂź
âAccurate and
complete coding is a
must in todayâs
economically
challenged healthcare
environment.â
4. Page 4 Coding Yesterdayâs Nomenclature Today
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