ICD-10-PCS: New Coding Clinic Advice on Application of the Coronary Arteries Additions

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

The code sets are posted by CMS in June of every year. The Coordination and Maintenance meeting in Baltimore often provides insight but changes and additions can be made without a detailed discussion of the issues leaving us to speculate on how we will apply them. Sometimes Coding Clinic surprises us.

The advice on how to code the coronary artery additions provided in Coding Clinic 4th quarter 2019 differs from our original understanding of these additions when we were developing our ICD-10-PCS FY2020 Updates course this summer. I wanted you to know that Coding Clinic has now published their advice on the real use of these codes.

Based on information found in Coding Clinic 4th quarter 2019 on pages 23 through 26, there is now common understanding about how CMS intended the coronary artery additions to be coded in FY2020. It is now apparent that CMS wants the Graftmaster and Papyrus stents to be coded as Supplement, using this root operation as the Not Elsewhere classifiable root operation. These stents restrict the opening in a ruptured vessel but rather than place the coronary arteries in the Restriction table for just one procedure, Supplement seems to the choice.

The same Coding Clinic tells us that the coronary artery body part values in the Insertion table are to be used for the placement of the prophylactic stents in the BASILICA procedure, performed with a valve-in-valve transcatheter aortic valve replacement. Coding Clinic 4th quarter 2019 gives us a good description of this procedure and the use of the intraluminal device in this way.


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About the Author

Lynn Kuehn is president of Kuehn Consulting, LLC, in Waukesha, Wisconsin, a consulting firm specializing in ICD-10-PCS coding for the inpatient setting. Lynn is a nationally recognized trainer on ICD-10-PCS and other HIM-related topics. Lynn served on the AHIMA Board of Directors and authored several of AHIMA’s most popular books including ICD-10-PCS: An Applied Approach and Procedural Coding and Reimbursement for Physician Services. Together with her co-Author Theresa Jorwic, Lynn received the Triumph Literary Legacy Award from AHIMA for ICD-10-PCS: An Applied Approach. Called the “go-to” resource for learning and mastering ICD-10-PCS, ICD-10-PCS: An Applied Approach provides step-by-step instructions and exercises at all levels, and is used throughout Kuehn’s ICD-10-PCS courses authored for Libman Education.

One thought on “ICD-10-PCS: New Coding Clinic Advice on Application of the Coronary Arteries Additions

  1. Michelle Dameron - October 16, 2019 at 3:35 pm

    I need Lynn as my mentor