# patient diagnosis arteriosclerotic heart disease



## SRENEECAMERON (Jul 30, 2011)

I am a student wanting to get into specialty cardiology coding. My teacher gave us a case where a patient came in and whose post op diagnosis was arteriosclerotic heart disease. The MD performed a coronary artery bypass graft X 5. I coded the CPT codes correctly but when it came to the ICD-9 code I put 429.2 and my teacher's answer was 414.00. We discussed the differences between the two codes and she could understand where I came up with the 429.2. The thing we could not understand was the difference between cardiovascular disease and heart disease. The definition in the medical dictionary was redunant so we came to a conclusion that either one of us could be correct. Could someone help me to figure out what would have been the correct code. I want to make sure I understand the difference so that when I run across this type of scenerio again I will know the difference.


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## jackson7591 (Jul 30, 2011)

*Differences*

Really really briefly:
414.00 Atherosclerotic coronary artery disease specifically refers to the arterial vessels directing blood flow to the cardiac tissues, most prominately (though not exclusively) the myocardium.
Conditions associated with 414.0 deal directly with accumulation of plaque in these vessels.   Clinical manifestations relate to damage to or death of issues receiving blood flow from these arteries.  Note, reduced blood flow through these vessels due to any other cause would be a different condition, i.e. Thrombus, embolus, spasm, trauma.

492.2 cardiovascular disease refers to all the organs of the cardiovascular system, arteries, capillaries, veins and the heart and its associated vessels.  Clinical manifestations relate to damage or death of tissues that receive arterial blood and or send venous blood from or to the heart respectively, including tissues of the heart itself.  So basically, most every organ/tissue is or can be affected by cardiovascular disease.  Also, cardiovascular disease does not specifiy the mechanism of the failure.


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