Cardiology Coding Alert

Question: Which diagnosis code is appropriate for Port-a-Cath malfunction? Is it a V code?

New York Subscriber

Answer: The proper code depends on the specific "complication" or "malfunction" type, so you would need more information to choose the best code.

Typically, you'll choose a complication code from the following options:

• 996.1 -- Mechanical complication of other vascular device, implant, and graft

• 996.62 -- Infection and inflammatory reaction due to internal prosthetic device, implant, and graft; due to other vascular device, implant, and graft (requires an additional code to specify the infection, such as sepsis)

• 996.74 -- Other complications of internal (biological) (synthetic) prosthetic device, implant, and graft; due to other vascular device, implant, and graft

• 999.31 -- Infection due to central venous catheter (requires an additional code to specify the infection, such as sepsis).

Once you've chosen the appropriate primary code, you should report E878.8 (Other specified surgical operations or procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at the time of operation) as a secondary code on the claim.

The device: A physician places a Port-a-Cath under the chest's skin and inserts the catheter into the superior vena cava. The provider can feel the Port-a-Cath's edges under the skin, and she inserts a special needle (you may see it documented as a Huber needle) in the middle of the port. Providers may administer medication or draw blood through the Port-a-Cath.

You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, CCC, CPC, ACS-CA, CHCC, president of CardiologyCoder.Com.