How to Code Coronary Artery Disease Using ICD 10 and CPT Codes

How to Code Coronary Artery
Disease Using ICD-10 and
CPT Codes
Coronary artery disease occurs due to the
narrowing of the coronary arteries. The article
discusses the medical codes used to report this
disorder.
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Coronary artery disease (CAD) `develops due to the narrowing and
hardening of the coronary arteries, (the blood vessels that supply oxygen
and blood to the heart). Regarded as the leading cause of death for both
men and women in the United States, CAD begins when hard
cholesterol substances (plaques) thatget deposited within a coronary
artery results in the formation of tiny clots that can obstruct the flow of
blood to the heart muscle.Early-stage coronary artery disease often may
not generate any symptoms. However, the problem gets diagnosed only
when a routine checkup reveals a high cholesterol/blood pressure levels
or when the patient suffers a significant blockage or heart attack.The
condition is characterized by common symptoms like chest pain (angina
pectoris), heart attack (myocardial infarction), sweating, shortness of
breath and sudden death.Cardiologists treating this condition must
document the diagnosis and medical procedures with accurate medical
codes. Medical coding outsourcing can ensure timely and accurate claim
submission for optimal reimbursement for the medical services
provided.
Also called coronary heart disease (CHD), CAD is the most common
form of heart disease that affects about 16.5 million Americans above
the age of 20. Reports suggest that every 40 seconds, one person in the
US suffers a heart attack. A heart attack can come from uncontrolled
CAD. Incorporating positive lifestyle changes can help to prevent and
treat coronary artery disease.

Signs and Symptoms
Chest discomfort (angina) is one of the most common symptoms of
coronary artery disease. Some of the other related symptoms are –
 Pain in the arms or shoulders
 Shortness of breath
 Sweating
 Dizziness
 Nausea
 Irregular heartbeat
 Restlessness
 Perspiration and clammy skin
Generally, a number of risk factors can directly contribute to this
condition. The potential risk factors include – age, family history, sex,
smoking, physical inactivity, obesity, stress, diabetes, high blood
pressure and high cholesterol levels. A correct understanding about the
potential risk factors can help people to prevent or reduce the likelihood
of developing this disorder.
How to Diagnose and Document CAD
Diagnosing coronary artery disease requires a detailed review of medical
history, physical examination, routine blood test and other diagnostic
tests such as - Electrocardiogram (ECG), angiogram, cardiac
catheterization (left heart catheterization), echocardiogram, stress test

and heart CT scan. Treatment for this condition involves lifestyle
changes, and possibly some medical procedures and
medications.Lifestyle recommendations include quitting the habit of
smoking, reducing or stopping the consumption of alcohol, losing body
weight to a healthy level, eating a healthy diet, and exercising regularly.
Medications include – statins, calcium channel blockers, Beta blockers
and Angiotensin-converting enzyme (ACE) inhibitors. If your condition
doesn’t improve with lifestyle changes and medications, physicians may
recommend several procedures to increase blood flow to your heart and
these include - balloon angioplasty, coronary bypass surgery, enhanced
external counter pulsation and stent placement.
Medicare Part B covers screening blood tests for lipids, cholesterol, and
triglycerides once every 5 years to identify potential risk factors (like
heart attack or stroke) for cardiovascular diseases. In addition to
Medicare coverage, private insurance companies offer Medicare
Supplement plans.
Cardiology medical coding involves the use of specific ICD-10 codes
and CPT codes to document different cardiovascular conditions,
including coronary artery disease (CAD). Medical codes used for
documenting this disorder include –

ICD-10 Codes
 I25 – Chronic ischemic heart disease
 I25.1 – Atherosclerotic heart disease of native coronary artery
 I25.10 – Atherosclerotic heart disease of native coronary artery,
without angina pectoris
with angina pectoris
with unstable angina pectoris
with unstable angina pectoris, with documented spasm
with other forms of angina pectoris
with unspecified angina pectoris
CPT Codes
 92920 - Percutaneous transluminal coronary angioplasty; single
major coronary artery or branch
 92921- Percutaneous transluminal coronary angioplasty; each
additional branch of a major coronary artery
 92924 - Percutaneous transluminal coronary atherectomy, with
coronary angioplasty when performed; single major coronary
artery or branch

coronary angioplasty when performed; each additional branch of a
major coronary artery
 92928 - Percutaneous transcatheter placement of intracoronary
stent(s), with coronary angioplasty when performed; single major
coronary artery or branch
 92929 - Percutaneous transcatheter placement of intracoronary
stent(s), with coronary angioplasty when performed; each
additional branch of a major coronary artery
intracoronary stent, with coronary angioplasty when performed;
single major coronary artery or branch
intracoronary stent, with coronary angioplasty when performed;
each additional branch of a major coronary artery
 92937 - Percutaneous transluminal revascularization of or through
coronary artery bypass graft (internal mammary, free arterial,
venous), any combination of intracoronary stent, atherectomy and
angioplasty, including distal protection when performed; single
vessel
 92938 - Percutaneous transluminal revascularization of or through
venous), any combination of intracoronary stent, atherectomy and

angioplasty, including distal protection when performed; each
additional branch subtended by the bypass graft
 92941 - Percutaneous transluminal revascularization of acute
total/subtotal occlusion during acute myocardial infarction,
coronary artery or coronary artery bypass graft, any combination of
intracoronary stent, atherectomy and angioplasty, including
aspiration thrombectomy when performed, single vessel
 92943 - Percutaneous transluminal revascularization of chronic
total occlusion, coronary artery, coronary artery branch, or
coronary artery bypass graft, any combination of intracoronary
stent, atherectomy and angioplasty; single vessel
 92944 - Percutaneous transluminal revascularization of chronic
total occlusion, coronary artery, coronary artery branch, or
coronary artery bypass graft, any combination of intracoronary
stent, atherectomy and angioplasty; each additional coronary
artery, coronary artery branch, or bypass graft
 92973 - Percutaneous transluminal coronary thrombectomy
mechanical (List separately in addition to code for primary
procedure)
 92974 - Transcatheter placement of radiation delivery device for
subsequent coronary intravascular brachytherapy (List separately
in addition to code for primary procedure)
 92975 - Thrombolysis, coronary; by intracoronary infusion,
including selective coronary angiography

 92978 - Endoluminal imaging of coronary vessel or graft using
intravascular ultrasound (IVUS) or optical coherence tomography
(OCT) during diagnostic evaluation and/or therapeutic intervention
including imaging supervision, interpretation and report; initial
vessel
 92979 - Endoluminal imaging of coronary vessel or graft using
intravascular ultrasound (IVUS) or optical coherence tomography
(OCT) during diagnostic evaluation and/or therapeutic intervention
including imaging supervision, interpretation and report; each
additional vessel
 93454 - Catheter placement in coronary artery(s) for coronary
angiography, including intraprocedural injection(s) for coronary
angiography, imaging supervision and interpretation
angiography, imaging supervision and interpretation; with catheter
placement(s) in bypass graft(s) (internal mammary, free arterial,
venous grafts) including intraprocedural injection(s) for bypass
graft angiography
angiography, imaging supervision and interpretation; with right
heart catheterization

angiography, imaging supervision and interpretation; with catheter
placement(s) in bypass graft(s) (internal mammary, free arterial,
venous grafts) including intraprocedural injection(s) for bypass
graft angiography and right heart catheterization
angiography, imaging supervision and interpretation; with left
heart catheterization including intraprocedural injection(s) for left
ventriculography, when performed
angiography, imaging supervision and interpretation; with left
heart catheterization including intraprocedural injection(s) for left
ventriculography, when performed, catheter placement(s) in bypass
graft(s) (internal mammary, free arterial, venous grafts) with
bypass graft angiography
and left heart catheterization including intraprocedural injection(s)
for left ventriculography, when performed

and left heart catheterization including intraprocedural injection(s)
for left ventriculography, when performed, catheter placement(s)
in bypass graft(s) (internal mammary, free arterial, venous grafts)
with bypass graft angiography
 93571 - Intravascular Doppler velocity and/or pressure derived
coronary flow reserve measurement (coronary vessel or graft)
during coronary angiography including pharmacologically induced
stress; initial vessel
 93572 - Intravascular Doppler velocity and/or pressure derived
coronary flow reserve measurement (coronary vessel or graft)
during coronary angiography including pharmacologically induced
stress; each additional vessel
HCPCS Code
 C9600 - Percutaneous transcatheter placement of drug eluting
intracoronary stent(s), with coronary angioplasty when performed;
single major coronary artery or branch
 C9601 - Percutaneous transcatheter placement of drug-eluting
intracoronary stent(s), with coronary angioplasty when performed;
each additional branch of a major coronary artery

 C9602 - Percutaneous transluminal coronary atherectomy, with
drug eluting intracoronary stent, with coronary angioplasty when
performed; single major coronary artery or branch
 C9603 - Percutaneous transluminal coronary atherectomy, with
drug-eluting intracoronary stent, with coronary angioplasty when
performed; each additional branch of a major coronary artery (list
separately in addition to code for primary procedure)
 C9604 - Percutaneous transluminal revascularization of or through
venous), any combination of drug-eluting intracoronary stent,
atherectomy and angioplasty, including distal protection when
performed; single vessel
Healthcare providers and coding specialists must have the knowledge
and expertise to code each separate procedurecorrectly to avoid claim
denials and delayed payment. Outsourcing these coding tasks to a
reliable medical billing and coding company that offers the services of
AAPC-certified coders can make the coding process easy.

How to Code Coronary Artery Disease Using ICD 10 and CPT Codes

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How to Code Coronary Artery Disease Using ICD 10 and CPT Codes