Outpatient HCC Question : Disorder of arteries & arterioles versus Carotid Artery Stenosis/Occlusion

mpadolina@virtua.orgmpadolina@virtua.org
in CDI Expansion
Hello everyone, 

I have a conundrum as to when is it applicable to code for I77.9 : disorder of arteries & arterioles, unspecified

I reviewed a chart for a patient that has bilateral carotid stenosis >70%, and patient declines further workup and intervention for the bilateral CAS. Physician documented " bilateral carotid artery stenosis"  = I65.23 (non-HCC)

I then ran into another chart review with an almost exact scenario, however the physician documented "carotid artery disease" and coded I77.9 , Disorder of arteries & arterioles, unspecified = HCC diagnosis

If anyone can help shed some light over this it will be greatly appreciated

Thanks, Martha Padolina , RN CCDS 

Comments

  • achamberland@emhs.orgachamberland@emhs.org
    My team has had the same thought and has run into the same issue. It doesn't seem to make a lot of sense that if the provider specifies the carotid artery disease as stenosis then its not an HCC but if there is no mention of stenosis, then its an HCC. Odd for sure and would be interested to see what anyone else has for input. 
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