We have been focusing on procedures in the Administration section for the past few weeks. This will be our last week to discuss procedures in this section.
Problems for this week
- Epidural blood patch
- Transfusion of embryonic stem cells into central vein.
- Infusion of chemotherapy peripheral vein insertion.
Problem #1, Epidural blood patch.
To Locate: PCS Index > Introduction of substance in or on > Epidural Space > 3E0S3GC >
Locate table 3E0 and then scan the rows, looking for the character value S. Although it doesn’t
apply to this scenario, don’t necessarily stop at the first 4th character value you come to in a
particular row. Also remember that you have to stay within the same row. At any rate, we got a
break again, with the Index giving us the entire code. You should still locate the appropriate row
in table 3E0 and go across the row to validate that the code listed in the Index is correct:
Introduction of Other Therapeutic Substance into Epidural Space, Percutaneous Approach
- An epidural blood patch is a surgical procedure that uses auatologous blood in order to close one or many holes in the dura mater of the spinal cord, usually as a result of a previous lumbar puncture. The procedure can be used to relieve post dural puncture headaches caused by a spinal tap.
- How it works: A small amount of the patient’s blood is injected into the epidural space near the site of the original puncture; the resulting blood clot blood then “patches” the meningeal leak. An epidural needle is inserted into the epidural space at the site of the cerebrospinal fluid leak and blood is injected. The clotting factors of the blood close the hole in the dura.
- It is also postulated that the relief of the headache after an epidural blood patch is due to more of a compression effect than sealing the leak. Because the fluid column in the lumbar spine is continuous with the fluid around the brain, the blood exerts a “squeeze” and relieves the low pressure state in the head.
- By now you should be sufficiently aware of some of the new terminology, eg, Introduction is the new term for Injections.
Problem #2, Transfusion of embryonic stem cells into central vein.
To Locate: PCS Index > Transfusion > Vein > Central > Stem Cells > Embryonic > 302 > Locate table 302 and go across the row to finish building the code:
Transfusion of Embryonic Cells into Central Vein, Percutaneous Approach
- There are 3 body system (character 2) values in this section: Circulatory (0), Indwelling Device (C) and Physiological Systems and Anatomical Regions (E).
- Blood products are classified to the root operation “Transfusion”; Cleansing substances are classified to “Irrigation.” All other therapeutic, diagnostic, nutritional, physiological, or prophylactic substances administered are classified to “Introduction.”
- Catheter utilization to introduce substances into the circulatory system is classified to the Percutaneous approach.
Problem #3, Infusion of chemotherapy peripheral vein insertion.
To Locate: PCS Index > Introduction of substance in or on > Vein > Peripheral > Antineoplastic > 3E03 > locate table 3E0 and go across the row to finish building the code:
Introduction of Other Antineoplastic Peripheral Vein, Percutaneous Approach
- Remember that character value 3 is always used for the Administration section.
- It is very tempting to go to Infusion in the Index. If you do, it will send you to Introduction. Antineoplastics are therapeutic and therapeutic substances are classified to Introduction.
- By now you know that the approach in the Administration section is almost always going to be Percutaneous. This approach is used for intradermal, subcutaneous, and intramuscular injections.
- Qualifiers carry additional information for a particular procedure; in this in instance all we know is that chemotherapy was administered.