ICD-10 Coding for Stenosis(T82.855A, I65.22, M48.061)
Complete ICD-10-CM coding and documentation guide for Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stenosis
Occlusion and stenosis of cerebral arteries
Includes carotid stenosis, which is a common type of stenosis affecting cerebral blood flow.
T82.8Primary Range
Complications of cardiac and vascular prosthetic devices, implants and grafts
Covers in-stent restenosis, a critical condition in cardiology.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T82.855A | Stenosis of coronary stent | Use when angiography confirms stenosis within a coronary stent. |
|
| I65.22 | Occlusion and stenosis of left carotid artery | Use when imaging confirms significant stenosis in the left carotid artery. |
|
| M48.061 | Spinal stenosis, lumbar region without neurogenic claudication | Use when lumbar stenosis is confirmed without claudication symptoms. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for in-stent restenosis
Essential facts and insights about Stenosis
Primary ICD-10-CM Codes for stenosis
Decision Criteria
clinical Criteria
- Angiography confirms ≥50% stenosis in stent
documentation Criteria
- Explicit mention of 'in-stent restenosis'
Applicable To
- In-stent restenosis
Excludes
- Stenosis of native coronary artery (I25.10)
Clinical Validation Requirements
- Angiography showing ≥50% stenosis within stent
- Troponin elevation indicating myocardial infarction
Code-Specific Risks
- Misidentifying disease progression as a stent complication
Coding Notes
- Ensure documentation specifies 'in-stent restenosis' to avoid coding errors.
I65.22 - Occlusion and stenosis of left carotid artery
Use when imaging confirms significant stenosis in the left carotid artery.
Applicable To
- Left carotid artery stenosis
Excludes
- Bilateral carotid stenosis (I65.23)
Clinical Validation Requirements
- Doppler ultrasound showing ≥70% stenosis
- Peak systolic velocity ≥230 cm/s
Coding Notes
Ensure laterality is clearly documented to avoid coding errors.
M48.061 - Spinal stenosis, lumbar region without neurogenic claudication
Use when lumbar stenosis is confirmed without claudication symptoms.
Applicable To
- Lumbar spinal stenosis without claudication
Excludes
- Lumbar stenosis with neurogenic claudication (M48.062)
Clinical Validation Requirements
- MRI showing lumbar canal narrowing
- Absence of claudication symptoms
Coding Notes
Ensure documentation specifies absence of claudication.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other myocardial infarction type
I21.A9Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.10Occlusion and stenosis of bilateral carotid arteries
I65.23Spinal stenosis, lumbar region with neurogenic claudication
M48.062Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T82.855A.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential reimbursement issues.
Mitigation Strategy
Always document the affected side in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement errors., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use I25.10 unless angina is explicitly documented.
Impact
Reimbursement: Potential overbilling or underbilling., Compliance: Violation of coding specificity requirements., Data Quality: Misleading clinical data.
Mitigation Strategy
Require explicit documentation of claudication for M48.062.
Impact
Failure to differentiate between stent complications and native disease progression.
Mitigation Strategy
Implement regular training on angiography interpretation and documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stenosis
Use these documentation templates to ensure complete and accurate documentation for Stenosis. These templates include all required elements for proper coding and billing.
Coronary In-Stent Restenosis with NSTEMI
Specialty: CardiologyRequired Elements
- Angiography results
- Troponin levels
- ECG findings
- Clinical symptoms
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Stenosis? Ask your questions below.