General Surgery Coding Alert

Question: What is the correct diagnosis code for popliteal artery stenosis?

North Carolina Subscriber

Answer: You should look to 440.2x (Atherosclerosis of native arteries of the extremities).

The popliteal artery is an extension of the femoral artery and bifurcates into the tibial arteries. That places the popliteal arteries in the lower extremities. Code 440.2x applies to arteries in the extremities, so you know you're on the right track.

Look in the ICD-9 index under "Stenosis; artery; extremity," and the entry will point you to 440.20 (Atherosclerosis of native arteries of the extremities unspecified). When you turn to 440.20 in the tabular list, you'll see additional options in the range that may be more appropriate, depending on your documentation:

• 440.21, Atherosclerosis of native arteries of the extremities with intermittent claudication
• 440.22, ... with rest pain
• 440.23, ... with ulceration
• 440.24, ... with gangrene
• 440.29, Other atherosclerosis of native arteries of the extremities.

Follow the notes with each code to ensure you report an additional code if required.

For example: For all of the codes in the range, you should report 440.4 (Chronic total occlusion of artery of the extremities) as a secondary code if it applies to the patient's case.

Don't miss: The 440.2x codes apply to native arteries only. If the case instead involves a bypass graft, you should look to 440.30-440.32 (Atherosclerosis of bypass graft of the extremities).