AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 1; Ask the Editor

Carotid Artery Pseudoaneurysm Embolization Using Flow Diverter Stent and Coils

A patient with a pseudoaneurysm of the right internal carotid artery (ICA) presented for endovascular embolization. Following percutaneous access, intracranial views confirmed pseudoaneurysm of the cervical right internal carotid artery extending into the petrous (intracranial) segment of the artery. A duo microcatheter was placed into the pseudoaneurysm for coil delivery. Through a second catheter, a Surpass® Flow Diverter was deployed covering the entry into the pseudoaneurysm. Then, three coils were successfully deployed into the pseudoaneurysm to facilitate thrombosis. AP and lateral projections demonstrated coil mass within the pseudoaneurysm facilitating contrast stasis and adequate coverage of the pseudoaneurysm neck by the flow diverter. When a flow diverter is used in combination with coil embolization, is the flow diverter considered an adjunct device and not coded separately? What ICD-10-PCS codes are assigned in this case? ...

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