icd 9 code for stent thrombosis

Full Answer

What is the ICD 9 code for venous thrombosis?

Short description: VENOUS THROMBOSIS NOS. ICD-9-CM 453.9 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 453.9 should only be used for claims with a date of service on or before September 30, 2015.

What is the ICD 10 code for prosthetic thrombosis?

Thrombosis due to vascular prosthetic devices, implants and grafts, initial encounter. T82.868A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM T82.868A became effective on October 1, 2018.

What is suspected stent thrombosis?

Suspected stent thrombosis is an emergent condition which needs to be handled like any acute myocardial infarction. Laboratory studies (i.e., CBC, chemistry, cardiac enzymes) can be obtained at the time of patient presentation, but they should not slow referral to the catheterization laboratory.

What is the ICD 10 code for stent placement?

T82.855A Stenosis of coronary artery stent, initial encounter T82.857A Stenosis of other cardiac prosthetic devices, implants and grafts, initial encounter T82.867A Thrombosis due to cardiac prosthetic devices, implants and grafts, initial encounter

What is a stent thrombosis?

Stent thrombosis is a thrombotic occlusion of a coronary stent. This is usually an acute process in contrast to restenosis, which is a gradual narrowing of the stent lumen due to neointimal proliferation. Stent thrombosis often results in an acute coronary syndrome, while restenosis often results in anginal symptoms. Stent thrombosis is further defined according to the following characteristics: 1 Timing: early (within 1 month), late (from 1 to 12 months), and very late (more than 12 months). Timing is also sometimes categorized as acute (within 24 hours) or subacute (more than 24 hours). 2 Clinical scenario: stent thrombosis usually results in symptoms of an acute coronary syndrome; however, it can occasionally be clinically silent. 3 Underlying stent: bare-metal stent versus first generation drug-eluting stent versus second-generation drug-eluting stent thrombosis.

Why is stent thrombosis not reported?

Likely in the majority of cases, this is due to lack of antiplatelet therapy . This is especially a concern in the perioperative period. Other reasons for stent thrombosis can lie with the stent itself, such as stent underexpansion or malapposition (acute or delayed). This would only be discerned by intravascular ultrasound or optical coherence tomography, which should be considered in all cases of stent thrombosis.

What is the management of a stent?

The immediate management of stent thrombosis is the same as the management of an acute coronary syndrome. Patients who present with a non-ST-elevation acute coronary syndrome are usually managed invasively accordingly to local practice patterns. For example, these patients would usually undergo urgent catheterization. Medical management consists of antiplatelet therapy (i.e., aspirin, and an ADP receptor antagonist), antithrombin therapy (i.e., heparin or direct thrombin inhibitor), statin, beta-blocker, and nitroglycerin. Patients who present with an ST-elevation acute coronary syndrome should undergo emergent reperfusion therapy according to local practice patterns (i.e., normally by primary PCI). Successful reperfusion of an acute myocardial infarction from stent thrombosis is less likely than for acute myocardial infarction due to native artery/plaque rupture. Supportive medical therapy is the same as for non-ST-elevation acute coronary syndrome.

How often do stents thrombosis occur?

With bare-metal stents, most stent thromboses occur within the first month of implant at a frequency <1%.

How long should I keep aspirin after a stent?

Therefore, antiplatelet agents should be held for the shortest possible duration (i.e., not longer than 7 days).

What is a thrombus 5 mm proximal to the stent?

Definite stent thrombosis: a patient with clinical signs or symptoms of an acute coronary syndrome and angiographic or autopsy evidence of a thrombus 5 mm proximal or distal to the stent.

Which receptor antagonist raises the likelihood of stent thrombosis?

A consideration which raises the likelihood of stent thrombosis is recent termination of an adenosine diphosphate (ADP) receptor antagonist (i.e., clopidogrel, prasugrel, or ticagrelor) and/or aspirin.

Is distal embolic protection billable?

The deployment of a device for distal embolic protection during an interventional procedure is considered part of the more complex procedure and is not separately billable.

Can you use CPT in Medicare?

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of CMS internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Definition

• Stent thrombosis is a thrombotic occlusion of a coronary stent. This is usually an acute process in contrast to restenosis, which is a gradual narrowing of the stent lumen due to neointimal proliferation. Stent thrombosis often results in an acute coronary syndrome, while restenosis often results in anginal symptoms. Stent thrombosis is further def...

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