ICD-10-PCS, Root Operations – Part 24, Procedures: Question & Answer

ICD-10-PCS, Root Operations – Part 24, Procedures: Question & Answer

This week we are going to review the Obstetrics section as it relates to abortions. Abortion is defined as artificially terminating a pregnancy. Procedures performed on the products of conception are coded to the Obstetrics section. Procedures performed on the pregnant female other than the products of conception are coded to the appropriate root operation in the Med/Surg section. For example, Amniocentesis is coded to the products of conception body part in the Obstetrics section. Repair of obstetric urethral laceration is coded to the Urethra body part in the Med/Surg section.

 

Coding Problems for this Week:

  1. Manually assisted spontaneous abortion.
  2. D&C following incomplete spontaneous abortion.
  3. Transvaginal abortion using vacuum aspiration technique.

 

 

 

 

 

 

Who We Are

 

 

 

 

 

Answer Key

  1. 10E0XZZ
  2. 10D17ZZ
  3. 10D07Z6

 

  • Character 1, Section:  The first character is always 1, regardless of whether it is an abortion or delivery of an infant.
  • Character 2, Body System:  There is only one valid character value for character 2; 0 for Pregnancy.
  • Character 3, Root Operation:  There are 12 Root Operation in the Obstetrics section, two of which are unique to this section:
    • Abortion (character value A):  Abortion is subdivided according to whether an additional device such as an abortifacient or laminaria is used or whether the procedure was performed by mechanical means. If either an abortifacient or laminaria is used, the Approach is Via Natural or Artificial Opening. All other abortion procedures are those done by mechanical means (the products of conception are physically removed using instrumentation) and the device value is Z, No Device.
    • Delivery (character value E):  Assisting the passage of the Products of Conception from the genital canal. This Root Operation applies only to manually-assisted vaginal deliveries.
  • Character 4, Body Part. There are three Body Part values:
    • Products of Conception
    • Products of Conception, Retained
    • Products of Conception, Ectopic

 

Problem#1, Manually assisted spontaneous abortion

To Locate:  PCS Index > Delivery > Products of Conception > 10E0XZZ > Locate table 10E and go across the row to verify that the procedure given in the Index is correct:

Delivery of Products of Conception, External Approach

Root Ops 24, A

 

Problem #2, D&C following incomplete spontaneous abortion.

To Locate:  PCS Index > Extraction > Products of Conception > Retained > 10D1 > Locate table 10D and go across the row to finish building the code:

Extraction of Products of Conception, Retained, Via Natural or Artificial Opening

Root Ops 24, B

 

Problem #3, Transvaginal abortion using vacuum aspiration technique.

To Locate:  PCS Index > Extraction > Products of Conception > Vacuum > 10D07Z6 > Locate table 10D and go across the row to verify that the code given in the Index is correct:

Abortion of Products of Conception Vacuum, Via Natural or Artificial Opening

Root Ops 24, C 

Last week we reviewed the Administration section. We will continue our review by coding two problems from this section:

 

Coding problems for this week:

  1. Open implantation of antimicrobial envelope with cardiac pacemaker placement (do not code pacemaker).
  2. Percutaneous irrigation of ankle joint.

 

 

 

 

 

Who We Are

 

 

 

 

 

 

 

Answer Key:

  1. 3E0102A
  2. 3E1U38Z

 

Problem #1

To Locate:  PCS Index > Introduction > Subcutaneous Tissue > Anti-infective > 3E01 > locate table 3E0 and go across the row to finish building the code:

PCS Root Ops, 23 - A

This was a bit tricky. I went to Implantation and that didn’t work. Then I tried Insertion of device in and that didn’t work either. I finally tried Introduction and bingo!

 

Introduction: Putting ‘in’ or ‘on’ a therapeutic, diagnostic, nutritional, physiological, or prophylactic substance, except blood or blood products. Blood and blood products are coded to root operation ‘transfusion’.

 

CODING NOTE: ‘Body Part Value’ For the root operation Introduction, the body part value specifies where the procedure occurs and not necessarily the site where the substance introduced has an effect.

 

Examples:

- Antineoplastic/therapeutic agent infusion

- Transabdominal in-vitro fertilization

- Chemical pleurodesis with injection of tetracycline

- Insertion of rhBMP into bone

 

Problem #2, Percutaneous irrigation of ankle joint

To Locate:  PCS Index > Irrigation > Joint, Irrigating Substance > 3E1U38Z > Locate table 3E1 and go across the row to verify that the code is correct:

PCS Root Ops, 23 - B

Last week we reviewed the Placement section. Services performed in this section do not require puncture or incision and the approach is always external. This week we are going to continue our review by coding three more problems from the placement section.

 

Problems for this week:

  1. Sterile dressing to face wound.
  2. Cervical traction using a traction apparatus.
  3. Removal of stereotactic head frame.

 

 

 

 

 

 

 

 

Who We Are

 

 

 

 

 

 

 

Answer Key:

  1. 2W21X4Z
  2. 2W62X0Z
  3. 2W50XYZ

 

Problem #1, Sterile dressing to face wound.

To Locate:  PCS Index > Dressing > Face > 2W21X4Z:  Locate table 2W2 and go across the row to verify that the code is correct:

Dressing of face using bandage

Root Opps 22, a

  • Any device that remains on the person following the procedure is coded. A bandage is considered a device.

 

Problem #2, Cervical traction using a traction apparatus

To Locate:  PCS Index > Traction > Neck > 2W62X > locate table 2W6 to verify character 6 and to assign 7th character:

Traction of neck using traction apparatus

Root Opps 22, b

  • Traction is defined as exerting a pulling force on a body region in a distal direction.

 

Problem #3, Removal of stereotactic head frame.

To Locate:  PCS Index > Removal > head > 2W50X > locate table 2W5 and go across the row to verify characters 4-5 and to assign characters 6-7:

Removal of other device on head

Root Opps 22, c 

  • “Other Device,” character 6 is assigned a value of Y because removal of a stereotactic head frame was not an option.

We have primarily focused on inpatient procedures in the Coding Tidbits. However, most hospitals require dual coding for outpatient procedures, both ICD and CPT. The Placement section includes several types of outpatient procedures, procedures which we will discuss this week.

  • Placement procedures involve services performed without making any incision or puncture.
  • The 7 characters that make up a PCS code in this section are almost the same as those in the Med/Surg section.
  • Character 1:  Always Placement
  • Character 2, Body System:  There are only 2 character values for the 2nd character:
    • Anatomical Regions such as head, right inguinal region, abdominal wall, etc.
    • Anatomical Orifices such as mouth, pharynx, ear, urethra, etc.
    • Character 3, Root Operation:  Compression, Dressing, Immobilization, Packing and Traction.
    • Character 4, Body Region:  There are 2 general types of Body Regions in the Placement section which correspond to the 2nd character Body System values:  W for Anatomical Regions or Y for Anatomical Orifices.
    • Character 5, Approach:  There is only one valid 5th character for Approach in the Placement section – X for External. No incision or puncture is made and the procedures are either performed on the skin or mucous membranes or by the use of force or external pressure.
    • Character 6, Device:  The Device character typically designates the material used in a placement procedure such as splint, cast, brace, etc.
    • Please note that at this time there are no valid characters for the 7th character filed for Placement procedures. Therefore, assign Z, No Qualifier, for all procedures.

 

Coding problems for this week:

  1. Insertion of nasal packing.
  2. Placement of pressure dressing on abdominal wall wound.
  3. Splint placement, right lower leg.

 

 

 

 

Who We Are

 

 

 

 

 

Answer Key:

  1. 2Y41X5Z
  2. 2W13X6Z
  3. 2W3LX1Z

 

Problem #1, Insertion of nasal packing.

To Locate:  PCS Index > Packing > Nasal > 2Y41X5Z > Locate table 2Y4 to verify that the code given in the Index is correct:

Packing of nasal region using packing material

PCS Root Ops, 21 - A

 

 

Problem #2, Placement of pressure dressing on abdominal wall wound.

To Locate:  PCS Index > Abdominal Wall > 2W13X > locate table 2W1 and go across the row to complete the code:

Compression of abdominal wall using pressure dressing

PCS Root Ops, 21 - B

 

 

Problem #3, Splint placement, right lower leg.

To Locate:  PCS Index > Immobilization > Leg > Lower > Right > 2W3QX > Locate table 2W3 to complete the code:

Immobilization of right lower extremity using splint

PCS Root Ops, 21 - C

 

Last week we discussed guidelines for biopsies. This week we will focus on the guidelines for Inspection procedures. Inspection is defined as visually and/or manually exploring a body part. Visual exploration may be performed with or without optical instrumentation. Manual exploration may be performed directly or through intervening body layers. We will go over the guidelines first followed by some coding procedures that will give you an opportunity to put these guidelines into practice.

 

INSPECTION GUIDELINES

Guideline B3.11a:  Inspection of a body part(s) performed in order to achieve the objective of a procedure is not coded separately.

Example - Fiberoptic bronchoscopy performed for irrigation of bronchus, only the irrigation procedure is coded.

 

INSPECTION OF TUBULAR AND NON-TUBULAR BODY PARTS

Guideline B3.11b:  If multiple tubular body parts are inspected, (e.g., esophagus, blood vessel, ureter), the most distal body part inspected is coded. If multiple non-tubular body parts in a region are inspected, the body part that specifies the entire area inspected is coded.

Examples - Cystourethroscopy with inspection of bladder and ureters is coded to the ureter body part value.
Exploratory laparotomy with inspection of abdominal contents is coded to the peritoneal cavity body part value.

 

INSPECTION AND OTHER PROCEDURES PERFORMED ON SAME BODY PART

Guideline B3.11c:  When both an Inspection procedure and another procedure are performed on the same body part during the same episode, if the Inspection procedure is performed using a different approach than the other procedure, the Inspection procedure is coded separately.

Example - ‘Endoscopic’ Inspection of the duodenum, (e.g, EGD), is coded separately when ‘open’.
Excision of the duodenum is performed during the same procedural episode.

 

 

PROCEDURES FOR THIS WEEK:

  1. Fiberoptic bronchoscopy performed for irrigation of bronchus.
  2. Cystourethroscopy with inspection of bladder and ureters.
  3. EGD followed by open excision of the duodenum.

 

 

 

 

 

Who We Are

 

 

 

 

 

 

 

ANSWER KEY:

  1. 3E1F88Z
  2. 0TJ98ZZ
  3. 0WJP8ZZ, 0DB90ZZ

 

Problem #1, Fiberoptic bronchoscopy performed for irrigation of bronchus

To Locate:  PCS Index > Irrigation > Respiratory Tract, Irrigating Substance > 3E1F > locate table 3E1 and go across the row to complete the code:

Irrigation of Respiratory Tract Using Irrigating Substance Via Natural or Artificial Opening Endoscopic

PCS Root 20, a

 

Problem #2, Cystoureteroscopy with inspection of bladder and ureters.

To Locate:  Inspection > Ureter > 0TJ9 > Locate table 0TJ and go across the row to finish building the code:

Inspection of Ureter, Via Natural or Artificial Opening Endoscopic

PCS Root 20, b

 

Problem #3, EGD followed by open excision of the duodenum.

To Locate:  PCS Index > EGD > 0DJ08ZZ > Even though the Index gives you the code, you should still go to table 0DJ and go across the row to verify that the characters are correct:

Inspection of Upper Intestinal Tract, Via Natural or Artificial Opening Endoscopic

PCS Root 20, c

 

 

Problem #3 Cont’d: PCS Index > Excision > Duodenum > 0DB9 > Locate table 0DB and go across the row to finish building the code: 

Excision of Duodenum, Open Approach

PCS Root 20, d

 

 

For the past few weeks we have worked on root operations that take out some or all of a body part. We are going to continue our discussion, focusing on excision and resection procedures.

Coding problems for this week:

  1. Laparoscopic excision of right ovarian cyst followed by a total oophorectomy.
  2. Right breast lumpectomy followed by total mastectomy, open approach.

 

 

 

 

 

Who We Are

 

 

 

 

 

 

Answer Key:

  1. 0UB04ZX; 0UT04ZZ
  2. 0HBT0ZX; 0HBT0ZX

 

Problem #1, Laparoscopic excision of right ovarian cyst, diagnostic.
To Locate:  PCS Index > Excision > Ovary > Right > 0UB0 > Locate table 0UB and go across the row to finish building the code:

Excision of right ovary, percutaneous endoscopic approach

PCS root 19 a 

Problem #1, Part 2 cont’d, Right Oophorectomy
To Locate:  PCS Index > Resection > Ovary > Right > 0UT0 > locate 0UT and go across the row to finish building the code:

Resection of right ovary, percutaneous endoscopic approach

PCS root 19 b

Definition, Excision vs. Resection:  Excision is defined as cutting out or off, without replacement, a portion of a body part, whereas Resection is defined as cutting out or off, without replacement, all of a body part

  • The qualifier DIAGNOSTIC is used to identify excision procedures that are biopsies.
  • New Guidelines, B3.4a, B3.4b
  • GL B3.4a, Biopsy Procedure:  Biopsy procedures are coded using the root operations Excision, Extraction, or Drainage and the qualifier Diagnostic. For example, lymph node sampling, partial nephrectomy, liver biopsy by excision of tissue….
  • GLB3.4b, Biopsy followed by more definitive procedure:  If a diagnostic Excision, Extraction, or Drainage procedure (biopsy) is followed by a more definitive procedure, such as Destruction, Excision or Resection at the same procedure site, BOTH the biopsy AND the more definitive treatment are coded. For example, a biopsy of the breast followed by a partial mastectomy at the same procedure site, both the biopsy and the partial mastectomy procedure are coded.
  • Approach:  Entry by puncture or minor incision, of instrumentation through the skin or mucous membrane and/or any other body layers necessary to reach and visualize the site of the procedure. A puncture is made in the abdomen followed by insertion of the scope. This is considered a laparoscopy.

 

Problem #2, Right breast lumpectomy followed by total mastectomy.
To Locate:  PCS Index > Lumpectomy > see Excision > Breast > Right > 0HBT > locate table 0HB and go across the row to finish building the code:

Excision of right breast, open approach, diagnostic

PCS root 19 c

Problem #2, Part 2 cont’d, Mastectomy
To Locate:  PCS Index > Mastectomy > see Resection, Skin and Breast > Breast > Right > 0HTT0ZZ> Even though the Index gives you the code, you should still refer to table 0HT and go across the row to verify that the code is correct:

Resection of right breast, open approach

PCS root 19 d

 

NOTE:  An ‘excision’ is coded when only a part of the organ is removed and there is a portion left behind.

 

Previously we reviewed root operations that take out some or all of a body part, including excision, resection, detachment, destruction and extraction. You matched root operations with the appropriate procedure. This week you are going to code some of those procedures.

 

Coding questions for this week:

  1. Rectal polyp fulguration.
  2. Suction D&C via natural opening endoscopic.
  3. Below knee amputation, right leg, “high.”

 

 

 

 

Who We Are

 

 

 

 

 

 

 

Answer Key:

  1. 0D5P4ZZ
  2. 0UDB7ZZ
  3. 0Y6H0Z1

Problem #1, Fulguration of rectal polyp via natural opening endoscopic

To Locate:  PCS Index > Fulguration > see Destruction > 0D5P > Go to table 0D5 and then go across the row to finish building the code:

Destruction of rectum, via natural or artificial opening endoscopic

Root PCS - 18 a

  • Fulguration: Physical eradication of all or a portion of a body part by the direct use of energy, force or a destructive agent.
  • Body Part:  When the site of a procedure is around or surrounding a body part, the procedure is coded to the body part named. The polyp, not the rectum, was destroyed. It’s a little tricky because the wording makes it sound as if the rectum, not the polyp, was destroyed.
  • Approach: Entry of instrumentation through a natural or artificial external opening to reach and ‘visualize’ the site of the procedure defines the approach, Via Natural or Artificial Opening Endoscopic. The scope was inserted through a natural opening, the anus, and the site of the procedure was the rectum. Other examples utilizing this approach include EGD, sigmoidoscopy, and urethroscopy.

 

Problem #2, Suction D&C (non-ob) via natural opening

To Locate:  PCS Index > Suction curettage (D&C) > see Extraction, Endometrium > 0UDB

> Find table 0UD and go across the row to finish building the code:

Extraction of endometrium, via natural or artificial opening

Root PCS 18 b

  • Extraction: Pulling or stripping out or off all or a portion of a body part by the use of force. Two other examples of extraction, for example, include forceps removal of teeth and vein stripping.
  • Approach: Entry of instrumentation through a natural or artificial external opening to reach the site of the procedure defines the approach, Via Natural or Artificial Opening. No visualization instrument is utilized (e.g., scope.) Examples of procedures utilizing this same approach include transurethral prostatectomy, endotracheal intubation, trans-vaginal cervical cerclage.

 

Problem #3, Below-knee amputation, right leg, at the proximal tibia/fibula

To Locate:  PCS Index > Amputation > see Detachment > Leg > Lower > Right > 0Y6C0Z > Even though the index gives you all but the 7th character, you should still verify the code by locating table 0Y6 and going across the row to validate characters 4, 5, and 6, plus assign the 7th character:

Detachment at right lower leg, high, open approach

Root PCS 18 c

  • Detachment: Cutting off all or a part of the upper or lower extremities.
  • Body Part: Amputation is performed by disarticulation or cutting through the bone. The body part value is the site of the detachment; the right leg in our scenario.
  • Qualifier:  A qualifier, if applicable, is assigned to further specify the level at which the extremity was detached. The disarticulation took place at the proximal portion of the shaft of the tibia/fibula, hence a qualifier of 1 is assigned to the 7th character.
  • Note:  “Detachment” procedures are found only in body systems “X” (“Anatomical Regions, Upper Extremities”) and “Y” (“Anatomical Regions, Lower Extremities”) because amputations are performed on the extremities, across overlapping body layers (e.g., skin, muscle, bone), and therefore cannot be coded to a specific musculoskeletal body system, such as bones or joints.
  • ICD-10-PCS has codes for 3 different types of extremity amputations:
  • High:  Amputation at the proximal portion of the shaft of the tibia/fibula or radius/ulna
  • Mid:  Amputation at the middle portion of the shaft of the tibia/fibula or radius/ulna
  • Low: Amputation at the distal portion of the shaft of the tibia/fibula or radius/ulna

This week we are reviewing root operations that “Take out some or all of a body part.” There have been previous discussions about these root operations. However, rather than throwing something new at you each week, a re-review may be helpful. The root operation, specified by the 3rd character, identifies the objective of the procedure.

PCS Root Op 17 table

Match the following root operations with the appropriate procedure(s): 

  1. Excision:  _____________                       
  2. Resection:  ____________                        
  3. Detachment:  __________                       
  4. Destruction:  __________                       
  5. Extraction:  ___________

 

A. Rectal polyp fulguration ovarian cyst

B. Laparoscopic excision of right

C. Suction D&C

D. Below knee amputation, right leg

E. Diagnostic dilatation and curettage

F. Laparoscopic right oophorectomy

G. Breast lumpectomy, right breast

H. Total mastectomy, left breast

I. Fulguration of endometrium via natural opening

 

 

 

 

Who We Are

 

 

 

 

Answer Key:

  1. B, G
  2. F, H
  3. D
  4. A, I
  5. C, E

 

Don’t worry about the ICD-10-PCS codes. The purpose of this exercise is to reinforce your understanding of the various procedures that may apply to the root operations. Next week I will review the codes and how to locate them.

 

Question for this week:           

  1. Left percutaneous cardiac catheterization.
  2. Swan-ganz catheter pulmonary artery

 

 

 

 

Who We Are

 

 

 

 

 

 

ANSWER KEY

  1. 4A023N7
  2. 4A133B3

ANSWER KEY RATIONALE

  1. Problem #1, Left percutaneous cardiac catheterization

To locate:  PCS Index > Catheterization > Heart > see Measurement, Cardiac > 4A02 >

Locate table 4A0 and go across the row to finish building the code:

Measurement of cardiac sampling and pressure, left heart, percutaneous approach

Section Body System Root Operation Body Part Approach Function Qualifier

4

A

0

2

3

N

7

Measurement and Monitoring Physiological Systems Measurement Cardiac Percutaneous Sampling and Pressure Left Heart
  • Measurement and Monitoring (M&M). Measurement determines the level of a physiological/physical function at a given point in time, whereas Monitoring determines the level of function repetitively over a period of time.
  • Function:  The 7 characters that make up a PCS code in this section are the same as those in the Med/Surg section with the exception of the 6th character, Function/Device. Character 6 in the M&M section represents the physiological/physical function being measured or monitored, such as conductivity, rhythm, and pulse. Devices being monitored include pacemakers, defibrillators, and stimulators.
  • Qualifier:  The 7th character designates more specific information about the function that is measured or monitored, such as whether it was performed intraoperatively, involved the Right Heart or Left Heart, etc. Commonly performed procedures in this section include EKGs, EEGs, and cardiac catheterizations.
  • Percutaneous Approach:  The catheter is inserted by puncturing an artery or vein, usually in the groin. The approach is considered percutaneous when the targeted site is done via puncture.
  1. Problem #2, Swan-Ganz catheter pulmonary artery

To Locate:  PCS Index > Monitoring > Arterial > Pressure > Coronary > 4A13 > Locate table 4A1 and go across the row to complete the code:

Monitoring of arterial pressure, pulmonary, percutaneous approach

Section Body System Root Operation Body Part Approach Function/Device Qualifier

4

A

1

3

3

B

3

Measurement and Monitoring Physiological Systems Monitoring Arterial Percutaneous Pressure Pulmonary
  • Swan-Ganz catheterization is the passing of the catheter into the right side of the heart and the arteries leading to the lungs to monitor the heart’s function and blood flow.
  • Its purpose is diagnostic. The pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery and the filling pressure (“wedge” pressure) of the left atrium.
  • Body System:  The Physiological Systems and Regions include body parts for arteries and veins, the products of conception, and the major body systems.
  • Function:  The function is to monitor the pressure in atrium/R. ventricle.

Qualifier:   The Qualifier, Pulmonary, gives more specific information about the procedure. This is a pulmonary artery catheterization.

Questions for this week:

  1. Cystoscopic dilation of right ureteral stricture, with stent placement
  2. PTCA of 3 coronary arteries, RCA, LAD and circumflex. The RCA and LAD were done with drug-eluting stents, and the left circumflex without a stent.

 

 

 

 

Who We Are

 

 

 

 

 

 

ANSWER KEY

  1. 0T768DZ
  2. 027134Z, 02703ZZ

ANSWER KEY RATIONALE

  1. Problem #1, Cystoscopic dilation R. ureteral stricture, with stent placement

To Locate:  PCS Index > Dilation > Ureter > Right > 0T76 > Locate table 0T7 and go across the row to complete the code:

Cystoscopic dilation right ureter with intraluminal device, via natural or artificial opening Endoscopic

Part 1

  • Dilation procedures expand the diameter of a tubular body part, most often a blood vessel. A dilation root operation involves making the orifice or lumen of the tube larger rather than smaller. Anal sphincter dilation and ERCP with balloon dilation of bile duct are two examples of other types of dilation.
  • Approach:  Via Natural or Artificial Opening Endoscopic is defined as “Entry of instrumentation through a natural or artificial external opening to reach and ‘visualize’ the site of the procedure.” The scope is inserted through the urethra, a natural opening. Stent placement required the use of a scope, the cystoscope. Some other examples of this approach include EGD and sigmoidoscopy.
  • Device: An intraluminal device is a device within the lumen of any tubular structure or organ. The lumen is the cavity or channel within a tube or tubular organ. In addition to our scenario of ureteral stent placement, some other examples include bare metal coils, esophageal stents and drug-eluting and non drug-eluting stents.

 

 

Problem #2, PTCA of 3 coronary arteries, RCA and LAD with drug eluting stents, left circumflex without stent

NOTE:  When the identical procedure is not performed on all coronary artery sites (such as whether a device is used), the procedures must be coded separately. The 2 sites with drug-eluting stent placement may be coded as one Body Part value (Coronary Artery, Two Sites), reportable with one code, but the artery that did not have stent placement must be coded separately.

To Locate PTCA, 2 coronary arteries, with stent placement:  PCS Index > Dilation > Artery > Coronary > 2 sites > 0271 > Locate table 027 and go across the row to complete the code:

Dilation of coronary artery, two sites with drug-eluting intraluminal device, percutaneous approach

Part 2

  • Drug-Eluting Stents:  The drug is slowly released into the vessel wall tissue over a period of 30 to 45 days to prevent the build-up of scar tissue that can narrow the reopened artery.
  • Percutaneous Approach:  A blood vessel is punctured in the groin area. A stent is threaded through the blood vessel to the targeted site. “Puncture” meets the definition of Percutaneous approach:  “Entry by puncture or minor incision….” Also see guideline B.54:
  • Guideline B.54: Procedures performed percutaneously via a device placed for the procedure are coded to the approach Percutaneous.
  • Device:  Devices that remain in the body at the conclusion of the procedure should be coded.
  • We still have to account for the circumflex artery. The angioplasty performed on the left circumflex artery, one of the major coronary arteries, was done without stent placement.

 

 

Problem #2 cont’d, Dilation of one coronary artery, percutaneous approach

To Locate:  Dilation > Artery > Coronary > one site > 0270 > Locate table 027 and go across the row to finish building the code:

Part 3

 

From the Blog

ICD-10-PCS, Root Operations – Part 24, Procedures: Question & Answer

This week we are going to review the Obstetrics section as it relates to abortions. Abortion is defiread more