ICD-10-PCS Hospital Coding for Impella 5.5™ with SmartAssist™

This video supports accurate, compliant coding practices for Impella 5.5^TM with SmartAssist^TM. Coding varies by documented approach and includes codes for conduit creation, device insertion, and cardiac assistance.

There are two documented approaches, each of which has its own codes:

• Axillary approach
• Direct aortic insertion approach

The complete coding picture for each approach includes codes for conduit creation, device insertion, and cardiac assistance. Each component should be supported by the medical record. Note: Device removal should only be separately reported when performed during a separate procedural session from insertion.

Axillary approach

When the documented approach is the minimally invasive axillary approach, there is one code for the right axillary conduit and another code for the left axillary conduit:

• Right axillary conduit code: X2HL0F9
• Left axillary conduit code: X2HM0F9

In addition to the codes for conduit creation, there are codes for device insertion and cardiac assistance:

• Insertion code for axillary insertion through a graft: 02HA3RZ
• Assistance code when the device is providing mechanical circulatory support (represents performance of cardiac output, continuous): 5A0221D

Therefore, the complete coding picture for right axillary insertion of a device through a graft, with the device providing mechanical circulatory support, is coded as X2HL0F9 + 02HA3RZ + 5A0221D.

Ascending aorta approach

When the documented approach is the direct aortic approach, the codes for conduit creation and devices insertion are as follows:

• Direct aortic conduit creation code: X2HX0F9
• Direct aortic insertion code: 02HA0RZ

When the device is providing mechanical circulatory support, the assistance code is the same as for axillary insertion: 5A0221D.