Cardiology Coding Alert

Check the I73.- range notes to keep up with all excluded diagnoses.

When documentation shows that a patient has peripheral vascular disease without getting more detailed, you have to use an unspecified code for your claim. Be sure you know where to turn when you swap ICD-9 for ICD-10 in 2014.

ICD-9-CM Code

443.9, Peripheral vascular disease unspecified

ICD-10-CM Code

I73.9, Peripheral vascular disease, unspecified

Peripheral vascular disease (PVD) is the name for diseases of the blood vessels (arteries and veins) located outside the heart and brain. Physicians often use the term PVD to indicate peripheral artery disease (PAD), which involves some degree of blockage of the arteries responsible for providing blood to internal organs and extremities.

ICD-9 coding rules: ICD-9 instructs you to use 443.9 for intermittent claudication NOS, peripheral angiopathy NOS, peripheral vascular disease NOS, and spasm of artery. You should not, however, use the code for atherosclerosis of the arteries of the extremities (440.20-440.22) or spasm of cerebral artery (435.0-435.9).

ICD-10 changes: ICD-10 doesn’t offer you surprises for this code. The includes and excludes lists are almost identical between ICD-9 and ICD-10.

Documentation: A long list of terms falls under this unspecified code. Among the many terms indexed to I73.9 are angina cruris, vasomotor changes, and Charcot’s syndrome. Work with the doctor to ensure the most specific diagnosis possible is documented to aid in final code choice.

Coder tips: Although the I73.9 excludes list doesn’t show cerebral artery spasm, the general excludes list for the I73.- range instructs you to use G45.9 (Transient cerebral ischemic attack, unspecified) for that diagnosis.

Remember: CMS has finalized the ICD-10 compliance date of Oct. 1, 2014. When ICD-10 goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.