K25.4: Chronic or unspecified gastric ulcer with hemorrhage
F10.20: Unspecified alcohol dependence, continuous use
0DT70ZZ: Resection of stomach, pylorus, open approach
To Locate Codes:
- K25.4: Index > Ulcer > Gastric > see Ulcer, stomach > with > hemorrhage > Tabular to verify > Use additional code to verify alcohol abuse and dependence (F10.-)
- F10.20: Index > Dependence > alcohol > Tabular to verify
Feedback for Diagnoses Codes:
- K25.4: Pyloric ulcer versus gastric ulcer: Under Ulcer, pyloric, the Index instructs you to see Ulcer, stomach. There is no reference to the pylorus under the main term/subterm Ulcer, stomach. In ICD-10-CM, a pyloric ulcer is coded to gastric ulcer.
- F10.20: There are many new combination codes in ICD-10-CM for alcoholism and its manifestations but not in this scenario. Here, even though there is a direct correlation between alcoholism and the bleeding ulcers, we must assign a separate code for alcohol addiction.
To Locate Px Code:
- 0DT70ZZ: Px Index > Resection > Stomach > Pylorus > 0DT7 > locate table ODT and go across the row to finish building the code:
An alternative method for procedure code assignment is to skip the Index altogether by going directly to the tables. These are the steps to take if you opt to go directly to the tables:
- Identify the section (Med/Surg) and then locate it in the PCS coding book. Med/Surg = 0 (1st character).
- Identify the body system (Gastrointestinal) and then go the Gastrointestinal section of the coding book. GI body system = D (2nd character)
- Identify the root operation (Resection – 3rd character). Note that root operations are listed alphabetically. Resection = T value. Now you have the first 3 characters, 0DT, and should be in table ODT.
- Identify the body part (4th character), pylorus of stomach = 7 value. We now have 4 characters = 0DT7.
- Identify the approach (5th character) Open = 0 with a value of 0. Now we’re up to 5 characters = ODT70.
- Determine whether a device was left in place. In our scenario, there are no devices = Z (no device). We’re now up to 6 characters = 0DT70Z
Determine if they are any qualifiers. There are not = Z (no qualifiers). We have built the code = 0DT70ZZ!