Cath lab procedures

rfoster@kdhcd.orgrfoster@kdhcd.org
in CDI Talk Archive
I have a couple of questions that have come from my staff. Can anyone help me with the answer?

1. What DRG's are used for cardiac ablation with/ without heart Cath ?

2. What DRG is used for a patient that had 2 separate heart caths during one admission episode ( due to dye load). 2 stents were placed each cath lab visit with a total of 4 stents during admission. Can DRG 246 be used? If not, what is the reasoning behind that?

Thanks for any and all help you can give!

Rebekah Foster, RN CCDS
Interim Manager of Clinical Documentation Improvement
Kaweah Delta Medical Center
400 W. Mineral King Ave.
Visalia, CA 93291
(559) 624-5085

Comments

  • lsipos@monument.healthlsipos@monument.health
    edited April 2016
    I Would say, that Yes, you can. From my perspective!

  • catladyrncatladyrn
    edited April 2016
    Percutaneous cardiac ablation is either DRG 250 or 251. A separate heart cath would not change that, as it is lower in the hierarchy.

    No, you cannot add up the number of stents during the admission to get to 4. It has to be four stents in the same procedure.

    Coding Clinic, Fourth Quarter 2013 Page: 91 Effective with discharges: October 21, 2013
    Question:
    A 70-year-old male was admitted for a two-stage coronary interventional procedure secondary to recent acute non-ST elevation myocardial infarction. On day one, he underwent percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) with placement of three drug-eluting stents. On day two, during the same admission, a PTCA of the left anterior descending (LAD) and placement of two drugeluting stents was carried out. Can code 00.48, Insertion of four or more vascular stents, be coded to report the total number of vascular stent insertions or should we assign codes 00.47 and 00.46 to separately identify each operative episode?
    Answer:
    The number of stents should be separately identified for each operative episode. For episode one, assign codes 00.66, Percutaneous transluminal coronary angioplasty [PTCA]; 36.07, Insertion of drug-eluting coronary artery stent(s); 00.40, Procedure on single vessel; and 00.47, Insertion of three vascular stents.
    For the second operative episode, assign 00.66, Percutaneous transluminal coronary angioplasty [PTCA]; 36.07, Insertion of drug-eluting coronary artery stent(s); 00.40, Procedure on single vessel; and 00.46, Insertion of two vascular stents.

    Renee

    Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
    Director, Clinical Documentation, Core Measures and Outcomes
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