Q&A: Coding for cardiac catheterization

Q: What does cardiac catheterization surgery entail and how is this procedure reported in ICD-10-PCS?

A: A cardiac catheterization involves insertion of a long, thin tube called a catheter into an artery or vein in the groin, neck, or arm, and threading through the blood vessels into the heart. This procedure is used to examine how well the heart is functioning and may be performed on the right, left, or bilateral ventricles.

The table for cardiac catheterization is in the Measurement and Monitoring section of ICD-10-PCS. If you look up “cardiac catheterization” in the Alphabetic Index, and locate the subterm “heart,” you will be directed to this table.

To build this code, the Section is character 4 (Measurement and Monitoring). The body system character is A (physiological systems) and the root operation is Measurement (character 0): determining the level of a physiological or physical function at a point in time.

The body part value is 2 (cardiac), the approach is typically percutaneous, but can also be open or via at natural or artificial opening (characters 0, 3, 7, or 8). The sixth character identifies the function, which is sampling and pressure. The qualifier identifies whether the procedure is a right, left, or bilateral cardiac catheterization.

Examples of ICD-10-PCS codes used to report this procedure are:

• 4A023N6, Measurement of cardiac sampling and pressure, right heart, percutaneous approach
• 4A023N7, Measurement of cardiac sampling and pressure, left heart, percutaneous approach
• 4A023N8, Measurement of cardiac sampling and pressure, bilateral, percutaneous approach

Editor’s note: This article originally appeared in JustCoding. This question was answered by Adrienne Commeree, RHIA, CPC, CPMA, CCS, CEMC, CPIP, a professor at Tacoma Community College, during the HCPro webinar, “Overcome ICD-10-CM/PCS Cardiovascular Coding Challenges.” This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment