Prepared by Provistas, Incorporated ICD-9-CM TABULAR LIST OF PROCEDURES CLASSIFICATION OF PROCEDURES Code also note: this instruction is used in the Tabular List for two purposes: 1) To code components of a procedure that are performed at the same time, and 2) To code the use of special adjunctive procedures or equipment. Includes Note: this note appears immediately under a two- or three-digit code title. The information further defines, or gives example of, the contents of the category. Excludes Note: Terms following the word "excludes" are to be coded elsewhere as indicated in each case. 0. PROCEDURES AND INTERVENTIONS, NOT ELSEWHERE CLASSIFIED (00) 00 Procedures and interventions, Not Elsewhere Classified 00.0 Therapeutic ultrasound Excludes: diagnostic ultrasound (non-invasive) (88.71-88.79) intracardiac echocardiography [ICE] (heart chamber(s)) (37.28) intravascular imaging (adjunctive) (00.21-00.29) 00.01 Therapeutic ultrasound of vessels of head and neck Anti-restenotic ultrasound Intravascular non-ablative ultrasound Excludes: diagnostic ultrasound of: eye (95.13) head and neck (88.71) that of inner ear (20.79) ultrasonic: angioplasty of non-coronary vessel (39.50) embolectomy (38.01, 38.02) endarterectomy (38.11, 38.12) thrombectomy (38.01, 38.02) 00.02 Therapeutic ultrasound of heart Anti-restenotic ultrasound Intravascular non-ablative ultrasound Excludes: diagnostic ultrasound of heart (88.72) ultrasonic ablation of heart lesion (37.34) ultrasonic angioplasty of coronary vessels (00.66, 36.09) 00.03 Therapeutic ultrasound of peripheral vascular vessels Anti-restenotic ultrasound Intravascular non-ablative ultrasound Excludes: diagnostic ultrasound of peripheral vascular system (88.77) ultrasonic angioplasty of: non-coronary vessel (39.50) 00.09 Other therapeutic ultrasound Excludes: ultrasonic: fragmentation of urinary stones (59.95) percutaneous nephrostomy with fragmentation (55.04) physical therapy (93.35) transurethral guided laser induced prostatectomy (TULIP) (60.21) 00.1 Pharamaceuticals 00.10 Implantation of chemotherapeutic agent Brain wafer chemotherapy Interstitial/ intracavitary Excludes: injection or infusion of cancer chemotherapeutic substance (99.25) 00.11 Infusion of drotrecogin alfa (activated) Infusion of recombinant protein 00.12 Administration of inhaled nitric oxide Nitric oxide therapy 00.13 Injection or infusion of nesiritide Human B-type natriuretic peptide (hBNP) 00.14 Injection or infusion of oxazolidinone class of antibiotics Linezolid injection 00.15 High-dose infusion interleukin-2 [IL-2] Infusion (IV bolus, CIV) interleukin Injection of aldesleukin Excludes: low-dose infusion interleukin-2 (99.28) 00.16 Pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance Ex-vivo treatment of vessel Hyperbaric pressurized graft [conduit] 00.17 Infusion of vasopressor agent 00.18 Infusion of immunosuppressive antibody therapy monoclonal antibody therapy polyclonal antibody therapy Includes: during induction phase of solid organ transplantation 00.19 Disruption of blood brain barrier via infusion [BBBD] Infusion of substance to disrupt blood brain barrier Code also chemotherapy (99.25) Excludes: other perfusion (39.97) 00.2 Intravascular imaging of blood vessels Endovascular ultrasonography Intravascular ultrasound (IVUS) Intravascular [ultrasound] imaging of blood vessels Virtual histology intravascular ultrasound [VH- IVUS] Note: real-time imaging of lumen of blood vessel(s) using sound waves Code also any synchronous diagnostic or therapeutic procedures Excludes: adjunct vascular system procedures, number of vessels treated (00.40-00.43) diagnostic procedures on blood vessels (38.21-38.29) diagnostic ultrasound of peripheral vascular system (88.77) intravascular imaging of vessel(s) by OCT (38.24- 38.25) magnetic resonance imaging (MRI) (88.91-88.97) therapeutic ultrasound (00.01-00.09) 00.21 Intravascular imaging of extracranial cerebral vessels Common carotid vessels and branches Intravascular ultrasound (IVUS), extracranial cerebral vessels Excludes: diagnostic ultrasound (non-invasive) of head and neck (88.71) 00.22 Intravascular imaging of intrathoracic vessels Aorta and aortic arch Intravascular ultrasound (IVUS), intrathoracic vessels Vena cava (superior) (inferior) Excludes: diagnostic ultrasound (non-invasive) of other sites of thorax (88.73) 00.23 Intravascular imaging of peripheral vessels Imaging of: vessels of arm(s) vessels of leg(s) Intravascular ultrasound (IVUS), peripheral vessels Excludes: diagnostic ultrasound (non-invasive) of peripheral vascular system (88.77) 00.24 Intravascular imaging of coronary vessels Intravascular ultrasound (IVUS), coronary vessels Excludes: diagnostic ultrasound (non-invasive) of heart (88.72) intracardiac echocardiography [ICE] (ultrasound of heart chamber(s)) (37.28) 00.25 Intravascular imaging of renal vessels Intravascular ultrasound (IVUS), renal vessels Renal artery Excludes: diagnostic ultrasound (non-invasive) of urinary system (88.75) 00.28 Intravascular imaging, other specified vessel(s) 00.29 Intravascular imaging, unspecified vessel(s) 00.3 Computer assisted surgery [CAS] CT-free navigation That without the use of robotic(s) technology Image guided navigation (IGN) Image guided surgery (IGS) Imageless navigation Code also diagnostic or therapeutic procedure Excludes: robotic assisted procedures (17.41-17.49) stereotactic frame application only (93.59) 00.31 Computer assisted surgery with CT/CTA 00.32 Computer assisted surgery with MR/MRA 00.33 Computer assisted surgery with fluoroscopy 00.34 Imageless computer assisted surgery 00.35 Computer assisted surgery with multiple datasets 00.39 Other computer assisted surgery Computer assisted surgery NOS 00.4 Adjunct Vascular System Procedures Note: These codes can apply to both coronary and peripheral vessels. These codes are to be used in conjunction with other therapeutic procedure codes to provide additional information on the number of vessels upon which a procedure was performed and/or the number of stents inserted. As appropriate, code both the number of vessels operated on (00.40-00.43), and the number of stents inserted (00.45-00.48). Code also any: angioplasty or atherectomy (00.61-00.62, 00.66, 39.50) endarterectomy (38.10-38.18) insertion of vascular stent(s) (00.55, 00.63-00.65, 36.06- 36.07, 39.90) other removal of coronary artery obstruction (36.09) 00.40 Procedure on single vessel Number of vessels, unspecified Excludes: (aorto)coronary bypass (36.10-36.19) intravascular imaging of blood vessels (00.21- 00.29) 00.41 Procedure on two vessels Excludes: (aorto) coronary bypass (36.10-36.19) intravascular imaging of blood vessels (00.21- 00.29) 00.42 Procedure on three vessels Excludes: (aorto) coronary bypass (36.10-36.19) intravascular imaging of blood vessels (00.21- 00.29) 00.43 Procedure on four or more vessels Excludes: (aorto) coronary bypass (36.10-36.19) intravascular imaging of blood vessels (00.21- 00.29) 00.45 Insertion of one vascular stent Number of stents, unspecified 00.46 Insertion of two vascular stents 00.47 Insertion of three vascular stents 00.48 Insertion of four or more vascular stents 00.49 SuperSaturated oxygen therapy Aqueous oxygen (AO) therapy SSO2 SuperOxygenation infusion therapy Code also any: injection or infusion of thrombolytic agent (99.10) insertion of coronary artery stent(s) (36.06-36.07) intracoronary artery thrombolytic infusion (36.04) number of vascular stents inserted (00.45-00.48) number of vessels treated (00.40-00.43) open chest coronary artery angioplasty (36.03) other removal of coronary obstruction (36.09) percutaneous transluminal coronary angioplasty [PTCA] (00.66) procedure on vessel bifurcation (00.44) Excludes: other oxygen enrichment (93.96) other perfusion (39.97) 00.5 Other cardiovascular procedures 00.50 Implantation of cardiac resynchronization pacemaker without mention of defibrillation, total system [CRT-P] NOTE: Device testing during procedure - omit code BiV pacemaker Biventricular pacemaker Biventricular pacing without internal cardiac defibrillator Implantation of cardiac resynchronization (biventricular) pulse generator pacing device, formation of pocket, transvenous leads including placement of lead into left ventricular coronary venous system, and intraoperative procedures for evaluation of lead signals. That with CRT-P generator and one or more leads Excludes: implantation of cardiac resynchronization defibrillator, total system [CRT-D] (00.51) insertion or replacement of any type pacemaker device (37.80-37.87) replacement of cardiac resynchronization defibrillator pulse generator only [CRT- D](00.54) replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P](00.53) 00.51 Implantation of cardiac resynchronization defibrillator, total system [CRT-D] NOTE: Device testing during procedure - omit code BiV defibrillator Biventricular defibrillator BiV ICD BiV pacemaker with defibrillator BiV pacing with defibrillator Biventricular pacing with internal cardiac defibrillator Implantation of a cardiac resynchronization (biventricular) pulse generator with defibrillator [AICD], formation of pocket, transvenous leads, including placement of lead into left ventricular coronary venous system, intraoperative procedures for evaluation of lead signals, and obtaining defibrillator threshold measurements. That with CRT-D generator and one or more leads Excludes: implantation of cardiac resynchronization pacemaker, total system [CRT-P](00.50) implantation or replacement of automatic cardioverter/defibrillator, total system [AICD] (37.94) replacement of cardiac resynchronization defibrillator pulse generator, only [CRT- D](00.54) 00.52 Implantation or replacement of transvenous lead [electrode] into left ventricular coronary venous system NOTE: Device testing during procedure - omit code Excludes: implantation of cardiac resynchronization defibrillator, total system [CRT-D](00.51) implantation of cardiac resynchronization pacemaker, total system [CRT-P](00.50) initial insertion of transvenous lead [electrode] (37.70-37.72) replacement of transvenous atrial and/or ventricular lead(s) [electrodes] (37.76) 00.53 Implantation or replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P] NOTE: Device testing during procedure - omit code Implantation of CRT-P device with removal of any existing CRT-P or other pacemaker device Excludes: implantation of cardiac resynchronization pacemaker, total system [CRT-P] (00.50) implantation or replacement of cardiac resynchronization defibrillator pulse generator only [CRT-D](00.54) insertion or replacement of any type pacemaker device (37.80-37.87) 00.54 Implantation or replacement of cardiac resynchronization defibrillator pulse generator device only [CRT-D] NOTE: Device testing during procedure - omit code Implantation of CRT-D device with removal of any existing CRT-D, CRT-P, pacemaker, or defibrillator device Excludes: implantation of automatic cardioverter/defibrillator pulse generator only (37.96) implantation of cardiac resynchronization defibrillator, total system [CRT-D] (00.51) implantation or replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P] (00.53) 00.55 Insertion of drug-eluting of other peripheral vessel(s) Endograft(s) Endovascular graft(s) Stent grafts Code also any: angioplasty or atherectomy of other non-coronary vessel(s) (39.50) number of vascular stents inserted (00.45-00.48) number of vessels treated (00.40-00.43) procedure on vessel bifurcation (00.44) Excludes: drug-coated peripheral stents, e.g., heparin coated (39.90) insertion of cerebrovascular stent(s) (00.63- 00.65) insertion of drug-eluting coronary artery stent (36.07) insertion of drug-eluting stent(s) of superficial femoral artery (00.60) insertion of non-drug-eluting stent(s): coronary artery (36.06) peripheral vessel (39.90) for other endovascular procedure (39.71-39.79) 00.56 Insertion or replacement of implantable pressure sensor (lead) for intracardiac or great vessel hemodynamic monitoring Code also any associated implantation or replacement of monitor (00.57) Excludes: circulatory monitoring (blood gas, arterial or venous pressure, cardiac output and coronary blood flow) (89.60-89.69) 00.57 Implantation or replacement of subcutaneous device for intracardiac or great vessel hemodynamic monitoring Implantation of monitoring device with formation of subcutaneous pocket and connection to intracardiac pressure sensor (lead) Code also any associated insertion or replacement of implanted pressure sensor (lead) (00.56) 00.58 Insertion of intra-aneurysm sac pressure monitoring device (intraoperative) Insertion of pressure sensor during endovascular repair of abdominal or thoracic aortic aneurysm(s) 00.59 Intravascular pressure measurement of coronary arteries Includes: fractional flow reserve (FFR) Code also any synchronous diagnostic or therapeutic procedures Excludes: intravascular pressure measurement of intrathoracic arteries (00.67) 00.60 Insertion of drug-eluting stent(s) of superficial femoral artery Code also any: angioplasty or atherectomy of other non-coronary vessel(s) (39.50) non-drug-eluting peripheral stents (39.90) number of vascular stents inserted (00.45-00.48) number of vessels treated (00.40-00.43) procedure on vessel bifurcation (00.44) Excludes: insertion of drug-eluting stent(s) of other peripheral vessel (00.55) that for other endovascular procedure (39.71- 39.79)