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Root Operation 6 P rocedures that Always Involve Devices

Root Operation 6 P rocedures that Always Involve Devices. Presented by: THIMA ICD 10 Committee. Procedures that always involve devices. Insertion – Root Operation H . Example : Percutaneous placement of pacemaker lead into the left atrium.

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Root Operation 6 P rocedures that Always Involve Devices

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  1. Root Operation 6Procedures that Always Involve Devices Presented by: THIMA ICD 10 Committee

  2. Procedures that always involve devices

  3. Insertion – Root Operation H Example: Percutaneous placement of pacemaker lead into the left atrium Putting in a non-biological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part.

  4. Let’s code percutaneous placement of lead into left atrium. • Insertion of device, atrium, left 02H7 • Go to table 02H with body part 7 (atrium, left) • Approach - Percutaneous -3 • Device – Cardiac Lead Pacemaker – J • Qualifier – Z – No qualifier • 02H73JZ

  5. Replacement – Root Operation R Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part Example: Total left knee arthroplasty with insertionof total knee prosthesis

  6. Coding Note:Replacement includes taking out the body part

  7. Let’s code total left knee arthroplasty with uncemented insertion of total knee prosthesis. • Replacement, joint, knee left 0SRD • Go to table 0SR with body part D (knee joint, left) • Approach – open – 0 • Device – synthetic substitute – J • Qualifier – uncemented – A • 0SRD0JA

  8. Supplement – Root Operation U Putting in or on biologic or synthetic material that physically reinforces and/or augments the function of a portion of a body part Example: Laparoscopic rightinguinal hernia repair with Marlex mesh

  9. Let’s code laparoscopic right inguinal hernia repair with Marlex mesh. • Supplement, inguinal region, right 0YU5 • Go to table 0YU with body part 5 (inguinal region, right) • Approach - percutaneous endoscopic - 4 • Device - Synthetic substitute – J • Qualifier - No qualifier – Z • 0YU54JZ

  10. Removal – Root Operation P Taking out or off a device from a body part Example: Removal of an endotracheal tube

  11. What body system would you use for the pulmonary artery? Upper arteries Heart and great vessels

  12. Coding Note:In the root operation removal, general body part values are used when the specific body part value is not in the table Example: Removal of Swan Ganz catheter from right pulmonary artery Body part is Y – Great Vessel

  13. Let’s code removal of an endotracheal tube. Removal device from trachea 0BP1 Go to table 0BP with body part 1 (trachea) Approach - External – X Device – endotracheal device – E Qualifier – no qualifier – Z 0BP1XEZ

  14. Change – Root Operation 2 Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without cutting or puncturing the skin or a mucous membrane. Example: Tracheostomy tube exchange

  15. Let’s code a tracheostomy tube change. Change, by device, tracheostomy device, trachea 0B21 Go to table 0B2 with body part 1 (trachea) Approach – external – X Device – tracheostomy device – F Qualifier – no qualifier – Z 0B21XFZ

  16. Revision –Root Operation W Correcting, to the extent possible, a malfunctioning or displaced device Example: Open revision of left hip replacement, with adjustment of the prosthesis

  17. Let’s code an open revision of left hip replacement, with adjustment of the prosthesis Revision of device in, joint, hip, left 0SWB Go to table OSW with body part B (hip joint, left) Approach – open – 0 Device – synthetic substitute – J Qualifier – no qualifier - Z 0SWB0JZ

  18. How to Master Root Operation Coding Practice Review the exercises and match the root operations to procedures Continue to practice, practice, and more practice to help you master procedure coding involving one of these devices

  19. Your Turn to Practice

  20. Match the procedure on the left with the correct root operation on the right. • Casting of nondisplaced fracture • Reduction of displaced fracture • Putting a pin in a nondisplaced fracture • Immobilization • Insertion • Reposition

  21. Chest tube replacement Change

  22. Relocation of pacemaker pocket Revision

  23. Right mastectomy with free TRAM flap reconstruction Replacement Image: breastcancer.org

  24. Percutaneous placement of bone growth stimulator electrode, left femoral shaft Insertion

  25. Cystoscopy with retrieval of right ureteral stent Removal Image: mayoclinic.org

  26. Open anterior colporrhaphy with polypropylene mesh reinforcement Supplement Image: urogyn-nj.com

  27. Questions ? ?

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