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1 Coding Cardiac Catheterization 2015 Anthelio Healthcare Solutions Inc. Proprietary and confidential. All Rights ICD-10 ExpressLearnFebruary 3, 2015 What Is Cardiac Catheterization?Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. A long, thin, flexible tube called a catheter is put into a blood vessel in the arm, groin, or neck and threaded to the heart. This portion of the catheterization is not the procedure; it is the percutaneous approach to the heart and great physician may put a special type of dye in the catheter. The dye will flow through the bloodstream to the heart. Then, the physician will take images of the heart, usually of the left heart (Left Cardiac Catheterization), but may be of the right heart, or of the left and right heart. This is coded as: Measurement, dye will make the coronary arteries visible on the pictures. This test is coronary angiography.

2 This is coded as: Fluoroscopy, Artery, Coronary OR Plain Radiography, Artery, CoronaryWhat Is Cardiac Ventriculography?Cardiac Ventriculography is a medical imaging test used to determine a patient's cardiac function most often in the left ventricle, but may be of the right ventricle, or of the left and right ventricle. Cardiac ventriculography involves injecting contrast media into the heart's ventricle(s) to measure the volume of blood pumped. This is coded as: Fluoroscopy, HeartICD-10-PCS Code structure in the Measurement and Monitoring Section:Measurement and Monitoring Section The Measurement and Monitoring section is section 4 of ICD-10 -PCS and includes codes procedures that determine the level of a physiological or physical function. The first character in the Measurement and Monitoring section is 4. ICD-10 -PCS Code structure in the Imaging Section:Imaging Section B is the value that represents the Imaging Section as the first characterExample:Procedure: Left heart catheterization, coronary angiography and left ventriculogram Description of Procedure: The right groin was prepped and draped in the usual sterile fashion and locally anesthetized.

3 The right femoral artery was entered with 18 gauge needle and J guide wire was introduced into descending aorta. A French left coronary artery catheter was introduced and selective injections using iodixanol were made into the left coronary artery. A right coronary artery catheter was introduced and selective injections using iodixanol were made of right coronary artery. The right coronary artery catheter was exchanged and the left heart catheterization was performed at rest with pressures being measured. The left ventriculogram was performed using iodixanol. Total fluoroscopy time: minutesExample Part 1: Left heart catheterization 4A023N7 ICD-10 -PCS IndexCatheterization see Dilation see Drainage see Irrigation see Insertion of device in Heart see Measurement, Cardiac 4A02 Character1 SectionCharacter2 BodySystemCharacter3 RootOperationCharacter4 BodySystemCharacter5 ApproachCharacter6 Function/DeviceCharacter7 QualifierICD-10-PCS TabularExample Part 2: Coronary angiography B2111ZZ A French left coronary artery catheter was introduced and selective injections using iodixanol were made into the left coronary artery.

4 A right coronary artery catheter was introduced and selective injections using iodixanol were made of right coronary artery. First, the coder needs to know is iodixanol a: High osmolar contrast? Low osmolar contrast? Other contrast? Second, the coder needs to know the number of arteries visualized Two, left coronary artery and right coronary artery Third, the coder needs to know the type of imaging done: Total fluoroscopy time: minutesICD-10-PCS Index Fluoroscopy Artery Coronary Multiple B211 Laser, Intraoperative B211 Single B210 Laser, Intraoperative B210 ICD-10 -PCS Tabular Example Part 3: Left ventriculogram using iodixanol B2151 ZZICD-10-PCS IndexFluoroscopy Heart Left B215 Right B214 Right and Left B216 ICD-10 -PCS TabularFinal codes for this procedure: Left heart catheterization 4A023N7 Coronary angiography B2111ZZ Left ventriculogram using iodixanol B2151 ZZNote.

5 The coder must be guided by documentation in the medical record of each individual case to make the correct code 5 Character1 SectionCharacter2 BodySystemCharacter3 Root TypeCharacter4 Body PartCharacter5 ContrastCharacter6 QualiferCharacter7 QualifierSectionBody SystemOperationMeasurement and MonitoringPhysiological SystemsMeasurement: Determining the level of a physiological or physical function at a point in time 4A00 Open3 Percutaneous6 Right Heart7 Left Heart8 BilateralN Sampling and PressureBody SystemApproachFuntion/DeviceQualifier2 CardiacSectionBody SystemTypeImagingHeartFluoroscopy: Single plane or bi-plane real time display of an image developed from the capture of external ionizing radiation on a fluorescent screen. The image may also be stored by either digital or analog means B210 High Osmolar1 Low OsmolarY Other ConstrastZ NoneZ NoneBody PartContrastQualifierQualifier0 Coronary Artery, Single1 Coronary Artery, Multiple2 Coronary Artery Bypass Graft, Single3 Coronary Artery Bypass Graft, MultipleSectionBody SystemTypeImagingHeartFluoroscopy: Single plane or bi-plane real time display of an image developed from the capture of external ionizing radiation on a fluorescent screen.

6 The image may also be stored by either digital or analog means B210 High Osmolar1 Low OsmolarY Other ConstrastZ NoneZ NoneBody PartContrastQualifierQualifier4 Heart, Right5 Heart, Left6 Heart, Right and Left7 Internal Mammary Bypass Graft, Right8 Internal Mammary Bypass Graft, LeftF Bypass Graft, ICD-10 Fun CornerAnthelio's ICD- 10 obstetrics MatchCode GameDirections: Match the correct ICD-10 -CM code next to the following: 2015 Anthelio Healthcare Solutions Inc. Proprietary and confidential. All Rights pregnancy, 12 weeks gestation, undelivered, with mild hyperemesis abortion, complete, with hypertension pregnancy, third trimester, following of delivery, triplets, one cardiomyopathyThe answers are on the next page. The ICD-10 Fun CornerAnthelio's ICD- 10 obstetrics MatchCode Game Solution 2015 Anthelio Healthcare Solutions Inc. Proprietary and confidential. All Rights pregnancy, 12 weeks gestation, undelivered, with mild hyperemesis abortion, complete, with hypertension pregnancy, third trimester, following of delivery, triplets, one cardiomyopathy