Wiki ICD-9-cm code 429.2

[AlaskanCoder]

I teach coding at a local technical college and was posed a question I cannot figure out, so was hoping to find some help.
The text asks to code: Arteriosclerotic Cardiovascular Disease, unspecfied. For this, we find the code 429.2. However, the ICD-9-CM instructs to "use additional code to identify presence of arteriosclerosis" and does not give codes to reference. So, we looked up the term arteriosclorosis in the index and it led us to 440.9 "Generalized and unspecified artherosclerosis." However, the note says "excludes arteriosclerotic cardiovascular disease (ASCVD)(429.2)" So we went back arteriosclerosis in the index and looked for cardiovascular where it says "(see also Disease, cardiovascular) 429.2". So that sends us back to where we began still looking for the "Use additional code . . . " The text answer guide says the second code is 440.9 and reference the note in ICD-9-CM instructing you to use an additional code when 429.2 is used. So the text is no help here.

Can anyone tell us what is the correct additional code to identify the presence of arteriosclosis in ASCVD?

Thank you in advance for your clarification!
Karen Hill, CPC, CPMA

 

[mitchellde]

you cannot use an unspecified code to explain an unspecified code. The 429.2 needs an additional code to state if there is atherosclerosis and the location. the only info you get from 429.2 is that the patient has some form of cardiovascular disease. therefore is you have documentation of ASCVD you need to also know where.

 

[AlaskanCoder]

I understand that, Debra, but what I'm trying to get at is that every code I can find to "explain" 429.2 tells me that ASCVD is excluded, yet 429.2 tells me to use an additional code. We tried category 414, also, but that, eoo, says "Excludes ... (429.2)"
Just trying to figure out what additional code is correct.

 

[mitchellde]

any of the 440 codes except the 440.9, like I stated you cannot use an unspecified choice to explain further an unspecified code.