Saturday, June 20, 2020

Coding for AAA s/p Repair


Question:

How would an AAA be coded s/p EVAR? Is the coding the same with an open abdominal repair?

Answer:

Coding for an AAA s/p repair, will depend on the type of surgical procedure:
For patients with EVAR, assign codes:
 – I71.4, AAA, without rupture
 – Z95.828, presence of other vascular implants and grafts
In EVAR, the graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm. Over time, the aneurysm will shrink because of the lack of pressure on it. Patients who have an endovascular stent-graft must have the position of the stent-graft regularly monitored by a CT scan.

For patients who had an AAA open abdominal surgery repair, assign code:
 – Z95.828, presence of other vascular implants and grafts
In an open abdominal surgery, the damaged section of the aorta is removed and replaced with a synthetic tube (graft). In this case, the aneurysm no longer exists and would not be coded per ICD-10 guidelines.