AHA Coding Clinic® for ICD-9 - 2008 Issue 3; Ask the Editor

End Stent Restenosis

The patient is a 68-year-old female with a history of coronary artery disease status post stenting of the LAD and circumflex in 2005. She presented to the emergency department (ED) with unstable angina, was admitted and ruled out for acute myocardial infarction by enzyme analysis. She underwent repeat cardiac catheterization, which revealed 99% end stent restenosis of the left anterior descending artery (LAD). She was transferred to our facility to undergo coronary intervention. The patient had a successful percutaneous transluminal coronary angioplasty (PTCA), in kissing fashion, of the left anterior descending artery (LAD) and the first diagonal branch. This resulted in 5% residual in the first diagonal branch and 0% residual stenosis in the stented segment of the LAD. What is the appropriate code assignment for end-stent restenosis? Should this be coded as a complication of the stent? ...

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