Coding Tidbits Written By: Linda Kobayashi
Edited and Posted By: Andrea Wong
We announced in last week’s tidbit (Placement section) that we would start reviewing sections of the PCS coding book other than Med/Surg. Two weeks ago we focused on Placement. This week we are going to turn our attention to Administration. This section includes services such as injections, infusions and transfusions. This week’s lesson focuses on blood products from the Administration section.
This week’s coding problem: The patient has Lyme disease. To fight off the infection, her physician ordered transfusion of embryonic stem cells into a central vein.
A69.20 = Lyme Disease, Unspecified
30243AZ = Transfusion of embryonic stem cells into central vein, percutaneous approach
Breakdown of A69.20:
A69 = Other Spirochetal Infections
A69.2 = Lyme Disease
A69.20 = Lyme Disease, unspecified
To locate A69.20: Disease Index > Lyme Disease > A69.20
- The structure of the codes in the Administration section are the same as those in the Med/Surg with one exception: Character #6, Substance, replaces Devices.
- Blood products are classified to the root operation, Transfusion.
- Lyme Disease is an Autoimmune condition that is caused by the bacterium Borrelia burgdorferi which is transmitted to humans through the bite of infected ticks.
To locate 30243AZ: PCS Index > Transfusion > Vein > Stem Cells > Embryonic > 3023 > Locate table 302 and go across the row to finish building the code:
Transfusion of Embryonic Stem Cells Into Central Vein, Percutaneous Approach:
- Because finding the correct answer to this problem is very straight forward, I have no comments to make.
- Embryonic stem cells can turn into any cell type in the body.
- The injection of ESC has an immediate effect on strengthening the immune system. The main benefit from the stem cell treatment is the increased capacity of the body to defend itself from pathogenic invasion.
Directions for Locating the Codes by Going Directly to the Tables
Transfusion of Embryonic Cells
- Step #1 is to locate the correct section in your PCS coding book. If you don’t know which section is the correct one, simply flip through the various sections in your PCS coding book until you find Administration. The first character value is always 3.
- Step 2: Determine the correct Body System. Stay in the Administration section. The first 3 characters for all procedure codes (section, body system, and root operation) are listed. The body system is Circulatory. We now have our first 2 character values 30.
- Step 3: Determine the root operation. The root operations are listed alphabetically. Go through all the tables that start with 30, looking for the root operation, Transfusion. This is a fairly easy step because all you have to do to find Transfusion is to scan through all the tables starting with 30. Transfusion has a character value of 2. We now have 302, our first 3 characters.
- Step 4: Determine the body part. That should be easy enough because you know it involves the central vein and the central vein is part of the circulatory system with a character value of 4. We’re up to 4 characters, 3024.
- Step 5: Determine the approach. You already know the approach because it was stated in the problem, percutaneous. Any procedure that involves a puncture is considered percutaneous. We’re up to 5 characters, 30243.
- Step 6: Determine the substance injected. You know that the substance injected is embryonic stem cells (A). We are now up to 6 characters, 30243A.
- Step 7: Determine the qualifier. In our scenario, there is no qualifier, so we assign the placeholder of Z for a code of 30243AZ.