Cardiology Coding Alert

Question: The patient had endovascular repair of a descending thoracic aorta aneurysm in May 2014. I need to code a March 2015 repair of an endoleak. How should I report placement of a proximal extension prosthesis in the descending thoracic aorta that the cardiologist places using a balloon to seat under radiological guidance? Which ICD-9 and ICD-10 codes apply to an endoleak?

Texas Subscriber

Answer: Report the extension placement using 33883 (Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta [e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption]; initial extension).

You may report the radiological supervision and interpretation separately using 75958-26 (Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta [e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption], radiological supervision and interpretation; Professional component).

You also may report the catheterization separately using 36200 (Introduction of catheter, aorta).

You should choose a diagnosis code that shows the original endograft experienced a complication. Under ICD-9, report 996.1 (Mechanical complication of other vascular device implant and graft). Under ICD-10, report the leak using T82.330A (Leakage of aortic [bifurcation] graft [replacement], initial encounter).