C18.4: Malignant neoplasm of transverse colon
0DTL4ZZ: Resection of transverse colon, percutaneous endoscopic approach
0D1L4Z4: Bypass transverse colon to cutaneous, percutaneous endoscopic approach
To Locate Dx/Px Codes:
- C18.4: Index > Neoplasm Table > Malignant Primary column > intestine > large > colon > transverse
- 0DTL4ZZ: Px Index > Resection > Colon > Transverse > 0DTL > locate table 0DT and go across the row to finish building the code:
Resection transverse colon, percutaneous endoscopic approach
- Resection is defined in ICD-10-PCS as “Cutting out or off, without replacement all of a body part.” An ‘excision’ is coded when only a part of the organ is removed and there is a portion left behind. In our scenario, the entire transverse colon was resected.
- Approach is assigned to percutaneous endoscopic because the procedure was done via a laparoscope. A puncture or small incision has to be made in order to insert the scope.
- Directions for code assignment by coding directly from the table(s): You can also build the code by going directly to the appropriate table. Identify the section, the body system and the root operation. The section is Med/Surg = 0; the body system is Gastrointestinal = D; the root operation is Resection = T. Note that the root operations are listed alphabetically. You now have the first 3 characters, 0DT, and this puts you in the correct table. To assign the 4 remaining values for characters 4-7, you must identify the body part, the approach, and devices and qualifiers, if any:
- Body Part = L, Transverse colon
- Approach = 4, Percutaneous endoscopic
- Device = 0, No devices
- Qualifier = 0, No qualifiers
- You have now built the code, 0DTL4ZZ
- 0D1L4Z4: Px Index > Colostomy > see Gastrointestinal System > 0D1 > Locate table 0D1 and go across the row to finish building the code:
Bypass transverse colon to cutaneous, percutaneous endoscopic approach
- Bypass: Altering the route of passage of the contents of a tubular body part, i.e., rerouting the contents from one area of a body part to a downstream area in the normal route.
- Approach: Because the approach was via a laparoscope, it is considered to be percutaneous endoscopic.
- A colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. The attached stoma appliance provides an alternative channel for feces to leave the body.
- Device: Do not assign a value for device because the stoma appliance is an external, not an internal device. Only internal devices that remain after surgery are to be coded.
- Directions to locate code using tables instead of the index:
- Determine the section, Med/Surg = 0
- Select the appropriate body system = D, GI System
- Select the appropriate root operation = 1, Bypass
- We now have the first 3 characters, 0D1, which puts us in the correct table.
- To assign the 4 remaining values for characters 4-7, you must identify the body part, the approach, and devices and qualifiers, if any:
- Body part = L, Transverse Colon
- Approach = 4, Percutaneous Endoscopic
- Device = Z, No Device
- Qualifier = 4, Cutaneous
- You have now built the code, 0D1L4Z4