# Dx for Left posterior communicating artery aneurysm



## she803 (Apr 25, 2012)

Would ICD-9 code for left posterior communicating artery aneurysm be 747.81 or 430--or another code applied to this report?

Examination: MRA brain with and without contrast. 

Clinical indication: Left posterior communicating artery aneurysm.

Technique: An MRA of the brain was performed using 3-D time of flight imaging without contrast. Contrast enhanced MRA was also performed. Maximum intensity projections and multiplanar reformats were obtained. There is no prior MRA study for comparison. 

Findings: 
There is a focus of low signal intensity at the posteromedial aspect of the left internal carotid artery at the expected location of the left posterior communicating artery consistent with a unknown endovascular coil mass. There is a 1.6 x 1.6 x 1.6  mm outpouching of contrast material/flow related signal at the superolateral aspect of the coil mass.

The right internal carotid artery is normal in caliber. 

The middle and anterior cerebral arteries are normal. The anterior communicating artery is present. The posterior communicating arteries are normal.  The vertebral arteries and basilar artery are normal. The previously noted vasospasm of the posterior cerebral arteries has resolved.  


Impression: 

1.6 x 1.6 mm outpouching of contrast material/flow related signal at the superolateral aspect of the left posterior coil mass, which is likely an infundibulum at the origin of the left posterior communicating artery, a residual aneurysm is also considered but less likely given the recent normal cerebral angiogram.


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## jmcpolin (Apr 25, 2012)

so I take it this is post coil embolization?  Non ruptured aneurysm is 437.3 and ruptured is 430


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## she803 (Apr 25, 2012)

The report doesn't indicate whether or not it was ruptured but since it didn't indicate rupture then should I code it as 437.3?


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## jmcpolin (Apr 25, 2012)

yes I am sure if they were able to embolize it, it probably didn't rupture.


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