AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor

Mycotic Thoracoabdominal Aneurysm

A patient admitted with lower back pain, is diagnosed with a mycotic aneurysm of the distal descending thoracic aorta (thoracoabdominal). Cultures from the aneurysm site were found to be positive for methicillin resistant staphylococcus aureus (MRSA). The physician specifically states that no endocarditis is present. However, indexing in ICD-9-CM leads to code 421.0, Acute and subacute bacterial endocarditis, for mycotic aneurysm of any site. What is the appropriate code assignment for a patient that has a mycotic aneurysm when the physician specifically states that no endocarditis is present? Is this code assignment still appropriate? Should an additional code be assigned to reflect the actual site of the aneurysm? ...

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