ICD-10 Coding for Percutaneous Coronary Intervention(I21.01, I25.111)
Complete ICD-10-CM coding and documentation guide for Percutaneous Coronary Intervention. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Percutaneous Coronary Intervention
I20-I25Primary Range
Ischemic Heart Diseases
This range includes codes for coronary artery disease and myocardial infarction, which are primary conditions treated with PCI.
Presence of coronary angioplasty implant and graft
This code is used to indicate the presence of a coronary stent following PCI.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I21.01 | ST elevation (STEMI) myocardial infarction of anterior wall | Use when documenting an acute STEMI of the anterior wall confirmed by ECG and elevated troponin levels. |
|
| I25.111 | Atherosclerotic heart disease of native coronary artery with angina pectoris | Use for patients with coronary artery disease presenting with angina. |
|
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 PCI
Essential facts and insights about Percutaneous Coronary Intervention
Primary ICD-10-CM Codes for percutaneous coronary intervention
Decision Criteria
clinical Criteria
- Presence of ST elevation on ECG and elevated troponin levels
Applicable To
- Acute myocardial infarction with ST elevation
Excludes
- Non-ST elevation myocardial infarction (NSTEMI)
Clinical Validation Requirements
- ECG showing ST elevation ≥1mm in ≥2 contiguous leads
- Troponin levels ≥35x URL
Code-Specific Risks
- Incorrect sequencing with procedure codes
- Missing ECG or troponin documentation
Coding Notes
- Ensure proper sequencing of myocardial infarction codes before procedure codes.
I25.111 - Atherosclerotic heart disease of native coronary artery with angina pectoris
Use for patients with coronary artery disease presenting with angina.
Applicable To
- Coronary artery disease with angina
Excludes
- Atherosclerosis of bypass graft
Clinical Validation Requirements
- Angina symptoms with documented coronary artery stenosis
Coding Notes
Document angina and stenosis clearly to support code use.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Presence of coronary angioplasty implant and graft
Z95.5Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Percutaneous Coronary Intervention to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I21.01.
Impact
Clinical: Incomplete clinical records., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Always document stent type and size., Use standardized templates for procedure notes.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use T82.855- for stent stenosis and I25.7xx for CAD with stent.
Impact
Risk of audits due to missing details in PCI documentation.
Mitigation Strategy
Use detailed templates and checklists to ensure comprehensive 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 Percutaneous Coronary Intervention, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Percutaneous Coronary Intervention
Use these documentation templates to ensure complete and accurate documentation for Percutaneous Coronary Intervention. These templates include all required elements for proper coding and billing.
STEMI with PCI
Specialty: CardiologyRequired Elements
- ECG findings
- Troponin levels
- Vessel location
- Stent type and size
- Access site
- Complications
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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