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Avoiding and MI when coding Cardiac Cath & Percutaneous Coronary Intervention in ICD-10
Questions &Answers
Q: How is Iso-osmolar contrast coded?
A: Since iso-osmolar contrast is either high osmolar nor low osmolar, it is our opinion that Contrast
value Y, Other Contrast would be most appropriate.
Q: Is a filter wire the same thing as FFR?
A: Since fractional flow reserve (FFR) does not involve filtration, we do not believe that use of a “filter
wire” would be indicative of FFR being undertaken. We have seen FFR described as having been
accomplished through the use of a “pressure wire”. Please refer to Slide 21 for additional information.
Q: How do you count the sites (PTCA)?
A: Consider the following example cited in the ICD-10-PCS Guidelines for Coding and
reporting: Angioplasty of two distinct sites in the left anterior descending coronary artery with
placement of two stents is coded as Dilation of Coronary Arteries, Two Sites, with Intraluminal
Device. We can infer that a site is a unique intervention target (i.e. distinct). For example, angioplasty
and stenting of a single lesion (e.g. proximal RCA) would be considered one site, whereas angioplasty
and stenting of two lesions (e.g. proximal RCA and mid-RCA) would be considered two
sites. Interventionists typically describe their procedures according to target lesions, this actually sets
up pretty well for us!