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Cardiology Coding Alert

Reader Questions:

ID Iatrogenic CVA for Proper 997.02 Use

Published on Thu Aug 27, 2009

Question: Is 434.x the correct code for a postoperative cerebrovascular accident (CVA)? Nebraska Subscriber Answer: According to the ICD-9 official guidelines, the appropriate code for a postoperative CVA is 997.02  (Iatrogenic cerebrovascular infarction or hemorrhage) with a secondary code from cerebrovascular disease codes 430-432.x (subarachnoid, intracerebral, or other intracranial hemorrhage) -- or 433.xx-434.xx (artery occlusion) with a fifth digit of "1" -- to identify the type of hemorrhage or infarct. Term tip: "Iatrogenic" means unintentionally induced by a physician through medical or diagnostic procedures. The guidelines instruct that "the medical record documentation must specifically identify the cause and effect relationship of the procedure and the CVA" (www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm).
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