Reviewed on May 22, 2015
Question: The patient has an endoleak after an endograft procedure. Which diagnosis should be used for the endoleak?
Answer: The diagnosis that best describes an endoleak in a vascular endograft (for example, those used to repair abdominal aortic aneurysms, or AAAs) is 996.1 (mechanical complication of other vascular device, implant, and graft), says Gay Boughton-Barnes, CPC, MPC, CCS-P, senior medical compliance manager at the University of Oklahoma in Tulsa. Under ICD-10, report the leak using T82.330A (Leakage of aortic [bifurcation] graft [replacement, initial encounter).
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).
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