Current Procedural Terminology (CPT) code 414.00 will not have a direct crosswalk in ICD-10. This code should only have been used if the documentation shows that the patient has obstructive CAD involving coronary artery bypass conduits but the cardiologist didn’t specify the location of the obstruction.

Both ICD-9-CM and ICD-10-CM codes indicate whether CAD is in the native artery or a bypass graft.  ICD-10-CM code category I25.1 denotes CAD of a native artery.  Patients can also have CAD of several types of bypass grafts, including:

  • Unspecified (I25.700 – I25.709)
  • Autologous vein: i.e. , a vein that originates from the patient, such as the saphenous vein graft in the leg that is used to create a bypass in the coronary artery (I25.710 – I25.719)
  •  Autologous artery: i.e., an artery that originates from the patient, such as an internal mammary artery graft that is used to create a bypass in the coronary artery (I25.720-I25.729)
  • Non-autologous biological: i.e., the grafting material doesn't originate from the patient (I25.730-I25.739)
  • Transplanted heart. In this scenario, I25.75- for CAD of the native artery and I25.76- for CAD of a bypass graft should be reported.

CAD - NATIVE ARTERY

 ICD-10 Coding of Coronary Atherosclerosis of Unspecified Type of Vessel, Native or Graft 1

CAD – BYPASS GRAFT

Documenting the specific type of bypass graft is important because it affects the code assignment.

ICD-10 Coding of Coronary Atherosclerosis of Unspecified Type of Vessel, Native or Graft 2

Next Steps

Start to prepare for ICD-10, by including the following in your documentation for CAD today:

  1. Specify if the CAD is in the native artery or bypass graft
  2. If the CAD is in a bypass graft, specify the type of bypass graft
  3. Specify if the CAD also includes Angina, and if so, what type
This commentary is a summary prepared by McKesson’s Revenue Management Solutions division and highlights certain changes, not all changes, in 2014 CPT® codes relating to the specialty of radiology. This commentary does not supplant the American Medical Association’s current listing of CPT® codes, its documentation in the annual CPT Changes publications, and other related publications from American Medical Association, which are the authoritative source for information about CPT® codes. Please refer to your 2014 CPT® Code Book, annual CPT® Changes publication, HCPCS Book and Payer Bulletins for additional information, including additions, deletions, changes and interpretations that may not be reflected in this document.     

CPT is a registered trademark of the American Medical Association (“AMA”). The AMA is the owner of all copyright, trademark and other rights to CPT® and its updates.
Author - Female

About the author

Myra Blankenship, CIRCC, CPC of Compliance-Radiology, McKesson Business Performance Services.