Cardiology Coding Alert

Question: My doctor found an enlarged abdominal aorta on physical examination and is ordering an ultrasound to rule out an abdominal aortic aneurysm. What code should be used for the enlarged abdominal aorta since the aneurysm is considered "rule out" in this case?

Codify Member

Answer: If you don't have the findings of the exam to work with, consider 447.8 (Other specified disorders of arteries and arterioles). The index points to this code for "hypertrophy, artery NEC." Hypertrophy means abnormal enlargement.

If documentation shows confirmation of aortic ectasia, you should use 447.72 (Abdominal aortic ectasia). "Aortic ectasia refers to mild dilation of the aorta that is not defined as an aneurysm, usually less than 3 cm in diameter," according to ICD-9-CM Coding Clinic (2010, vol. 27, no. 4).

If exam findings show confirmation of an aortic aneurysm, you should report 441.3 (Abdominal aneurysm ruptured) if the aneurysm has ruptured or 441.4 (Abdominal aneurysm without rupture) if the aneurysm has not ruptured. You are correct that you should not report an aneurysm when documentation records a test is ordered to "rule out" that diagnosis but there is no confirmation of aneurysm.