Learn about Carotid Endarterectomy (CEA), also known as Carotid Artery Surgery. This resource provides information on CEA surgical procedures, clinical documentation requirements for Carotid Endarterectomy, and accurate medical coding for diagnosis code C related to carotid artery disease. Find details on postoperative care, complications, and best practices for healthcare professionals involved in the diagnosis and treatment of Carotid Endarterectomy.
Also known as
Extracranial arterial occlusion and stenosis
Covers procedures for carotid stenosis/occlusion.
Extracranial vascular procedures
Includes various extracranial vascular surgeries.
Cerebrovascular diseases
Encompasses conditions affecting blood vessels in the brain.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the carotid endarterectomy unilateral or bilateral?
Unilateral
Is there a stenosis documented?
Bilateral
Performed during same operative session?
When to use each related code
| Description |
|---|
| Surgical removal of plaque from carotid artery. |
| Balloon angioplasty and/or stent placement in carotid artery. |
| Medical management of carotid artery stenosis. |
Missing or incorrect laterality (right, left, bilateral) can lead to claim denials and inaccurate reporting for carotid endarterectomy.
Coding carotid stenosis (symptom) instead of carotid endarterectomy (procedure) if surgery is performed, leading to underpayment.
Incorrectly coding individual components of the CEA separately rather than using the comprehensive code, resulting in overbilling.
Q: What are the most reliable diagnostic criteria for determining carotid artery stenosis severity prior to considering carotid endarterectomy (CEA)?
A: Accurately determining carotid artery stenosis severity is crucial for appropriate CEA consideration. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, using duplex ultrasound and/or catheter angiography, are widely considered the gold standard. NASCET defines stenosis severity based on the ratio of the residual lumen diameter to the distal internal carotid artery diameter. Specifically, stenosis greater than 70% in symptomatic patients and greater than 79% in asymptomatic patients, confirmed by catheter angiography and correlated with ultrasound findings, is generally considered a threshold for CEA. Explore how incorporating NASCET criteria alongside other risk factors like patient symptoms and medical history can inform your decision-making process for CEA referral.
Q: How do I differentiate between asymptomatic and symptomatic carotid artery stenosis when evaluating a patient for potential carotid endarterectomy or carotid artery surgery?
A: Differentiating between asymptomatic and symptomatic carotid stenosis is essential for determining CEA candidacy. Symptomatic stenosis is defined by the presence of transient ischemic attack (TIA) or stroke in the corresponding carotid artery territory within the past 180 days. Symptoms may include focal weakness, sensory loss, amaurosis fugax, or dysphasia. Asymptomatic stenosis, on the other hand, presents without these neurological symptoms but is identified through imaging studies like carotid ultrasound or CT angiography. While both can lead to CEA, the degree of stenosis and patient-specific risk factors influence the decision. Consider implementing a thorough neurological assessment alongside appropriate imaging studies to accurately classify patients and guide CEA recommendations. Learn more about the specific criteria for CEA in asymptomatic versus symptomatic patients to tailor your approach.
Patient presents for evaluation and management of carotid artery stenosis. Symptoms include transient ischemic attack TIA, amaurosis fugax, or focal neurological deficits. Risk factors for carotid artery disease, such as hypertension, hyperlipidemia, diabetes mellitus, smoking history, and family history, were reviewed. Physical examination revealed a carotid bruit. Duplex ultrasound of the carotid arteries confirmed significant stenosis of the rightleft internal carotid artery, greater than 70-99% stenosis based on NASCET criteria. Cerebrovascular accident CVA risk stratification was performed. The patient was deemed a suitable candidate for carotid endarterectomy CEA, carotid artery surgery, to reduce stroke risk. Risks and benefits of the procedure, including perioperative stroke, myocardial infarction MI, cranial nerve injury, hematoma, infection, and restenosis, were discussed with the patient. Informed consent was obtained. Preoperative cardiac clearance was obtained. The patient will be scheduled for carotid endarterectomy with planned intraoperative neuromonitoring. Postoperative care will include close monitoring for neurological changes, wound complications, and blood pressure management. Follow-up duplex ultrasound will be scheduled to assess patency of the carotid artery. ICD-10 code I70.2, carotid stenosis, and CPT code 35301, carotid endarterectomy, are anticipated. This documentation supports medical necessity for carotid endarterectomy based on established guidelines for the management of carotid artery disease.