“In the kNOW” this month is going to explore an addition to the ICD-10-PCS New Technology section for FY2023 which is an intermittent coronary sinus occlusion device. Let’s begin by identifying what it is and its purpose.
An intermittent coronary sinus occlusion device is used when a patient is having an acute myocardial infarction. It resides in the coronary sinus after being inserted via a catheter from the femoral vein. The main purpose of the device is to increase the coronary sinus pressure and reduce the size of the infarction. This may also diminish the risk of post-MI heart failure. The insertion of this device is performed in conjunction with a primary percutaneous coronary intervention (PCI) when a patient has an acute myocardial infarction.
Let’s review how this is done:
In this picture we see the occluded vessel.
Next, an angioplasty is done of the vessel:
Here, we have the insertion of the intermittent coronary sinus occlusion device:
As you can see, when it is expanded, it is forcing the blood flow back in the ischemic area, reducing its size. (The grey area in the background is representing the infarct area.)
Finally, a stent is inserted to keep the previously occluded vessel open:
This is the New Technology table where you will find the code for this procedure:
This was just one of three procedures new to ICD-10-PCS for FY2023 which focused on reducing infarction size. One of the others was the use of supersaturated oxygen therapy to assist with reducing infarction size for patients with the most severe type of MI, a left anterior descending ST-elevation infarction (LAD STEMI), otherwise known as a widowmaker. The other procedure was a sphenopalatine ganglion neurostimulator lead used in the treatment of acute ischemic strokes. It has been shown to increase blood flow in the anterior cerebral circulation and decrease the infarction size in the brain.
Now you are In the kNOW!!
About the Author
Dianna Foley, RHIA, CCS, CHPS, CDIP is
OHIMA's Education Coordinator. Dianna has been an HIM
professional for over 20 years. She progressed through the ranks of coder,
department supervisor, and department director, to her current role as a
coding consultant. She previously served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati and holds RHIA, CHPS, CDIP and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and is a presenter on coding topics at the national, state, and regional levels. Dianna mentors new AHIMA members and also provides monthly educational lectures to coders and clinical documentation specialists.
