Answer Key Rationale
To Locate Codes:
Problem #1, VAD insertion:
Index > Insertion of device in > Subcutaneous Tissue and Fascia > Chest > 0JH6 > locate table 0JH6 and go across the row to finish building the code:
Insertion of vascular access device into chest subcutaneous tissue and fascia, percutaneous approach:
Problem #2, Total hip replacement:
Index > Replacement > Joint > Hip > Left > 0SRB > locate table 0SRB and go across the row to finish building the code:
Replacement of left hip joint with ceramic synthetic substitute, cemented, open approach
Problem #3, Abdominal wall herniorrhaphy using mesh:
Index > Supplement > Abdominal wall > 0WUF > locate table 0WUF and go across the row to finish building the code:
Supplement abdominal wall with synthetic substitute, percutaneous endoscopic approach
Problem #4, Drainage tube change:
Index > Change device in > Abdominal Wall > 0W2FX > Locate table 0W2FX and go across the row to assign the last two values to complete the code:
Change Drainage Device in Abdominal Wall, External Approach
Problem #5, Removal of spinal cord monitoring device:
Index > Removal of device from > Spinal Cord > 00PV > locate table 00PV and go across the row to finish building the code:
Removal of monitoring device from spinal cord, external approach
Change versus Removal: If a device is taken out and a similar device put in without cutting or puncturing the skin or mucous membrane, the procedure is coded to the root operation CHANGE. Otherwise, the procedure for taking out a device is coded to the root operation REMOVAL.
Problem #6, Revision cardiac pacemaker leads via thoracoscope:
Index > Revision of device in > Heart > 02WA > locate table 02WA and go across the row to finish building the code:
Coding of ‘Revision’
1) Revision always involves a device (synthetic/biologic) and includes correcting a malfunctioning device by taking out and/or reinserting part of or same device, or repositioning the device.
2) A complete re-do of a procedure is coded to the root operation performed and not to revision.
3) Removing a device and replacing it with an entirely new device via incision is coded to root operations ‘Removal’ and ‘Insertion’.
4) A complete re-do of a procedure is coded to the root operation performed and not to revision.