Aortic Aneurysms

The topic of discussion for “In the kNOW” this month will be coding for aortic aneurysms. To review, an aneurysm is weakening of a blood vessel wall that leads to dilation. If an aneurysm enlarges over time, it can lead to a rupture of the vessel wall and may result in death. There are different types of aneurysms which include:

Saccular-only one side of a vessel bulges

Fusiform-the bulge is all around the vessel

Pseudoaneurysm-only the outer wall of the vessel bulges; occurs with an inner vessel wall tear resulting in blood seeping through the other wall layers to create the pseudoaneurysm

Aortic aneurysms can occur in any part of the aorta. Typically, these aortic aneurysms are divided into thoracic or abdominal aneurysms. Thoracic aneurysms can happen in the aortic root, the ascending thoracic aorta, the aortic arch, or the descending thoracic aorta. The ICD-10-CM codes for thoracic aortic aneurysms are found in the I71.1x and I71.2x categories which identify not only the precise location of the aneurysm, if known, but also whether or not the aneurysm has ruptured. Abdominal aortic aneurysms can be specified as pararenal, juxtarenal, and infrarenal. In ICD-10-CM, the code series are I71.3X and I71.4x for these aneurysms which specify site and rupture status.

Source: http://www.emdocs.net/abdominal-aortic-aneurysm-clinical-highlights-updates/

You will notice that there is no specific ICD-10-CM code that identifies a suprarenal aortic aneurysm. In the second quarter Coding Clinic from 2024, a question was submitted asking what the appropriate code assignment would be for a suprarenal aortic aneurysm. The response was that a suprarenal aortic aneurysm is a type of pararenal aneurysm and therefore, codes I71.41 (without rupture), or I17.31 (with rupture) would be correct.

The last aortic aneurysm code ranges cover those aortic aneurysms that are thoracoabdominal in nature. Terms of specificity for this type of aneurysm are supraceliac or paravisceral. I71.5x and I71.6x are the code ranges for thoracoabdominal aortic aneurysms by type and rupture status.

Now you are In the kNOW!!

About the Author

Dianna Foley, RHIA, CCS, CDIP, CHPS, has 25 years of HIM experience. She’s an AHIMA-approved ICD-10-CM/PCS trainer, an AHIMA-published author, a participant in AHIMA credential item writing and exam development, and served on the AHIMA Nominating Committee. She presents on coding topics at the national, state, and regional levels and serves as OHIMA’s Education Coordinator.