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Chapter 12: Gastrointestinal and Hepatobiliary Systems

International Classification of Diseases Tenth Revision Procedure Coding System (ICD-10-PCS): An Applied Approach 2012 Edition. Chapter 12: Gastrointestinal and Hepatobiliary Systems. Gastrointestinal and Hepatobiliary System. Gastrointestinal system – body system D

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Chapter 12: Gastrointestinal and Hepatobiliary Systems

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  1. International Classification of Diseases Tenth Revision Procedure Coding System (ICD-10-PCS): An Applied Approach2012 Edition Chapter 12: Gastrointestinal and Hepatobiliary Systems

  2. Gastrointestinal and Hepatobiliary System • Gastrointestinal system – body system D -Esophagus, stomach, intestines, anus and rectum -Mouth and throat introduced in Chapter 10 • Hepatobiliary system – body system F -Closely connected to the gastrointestinal system

  3. Functions of the Gastrointestinal System • Ingestion of food • Mechanical digestion • Chemical digestion • Mixing and propelling movements • Absorption of nutrients and water • Elimination of waste products

  4. Organization of the Gastrointestinal System • Digestive System -See Figure 12.1 for specific organs -Stomach – see figure 12.2 -Mesentery and omentum – see figure 12.3 • Peritoneum – double-layered covering of intraperitoneal organs that forms the mesentery • Hepatobiliary System -Liver, gallbladder, pancreas and ducts -See figure 12.4

  5. Common Root Operations • Tubular body parts -Dilation -Occlusion -Restriction • Transplantation • Bypass – bariatric procedures - Restriction for gastric bands -Excision for sleeve gastrectomy

  6. Multiple Procedures • See Coding Guideline B3.2c – multiple procedure codes for multiple root operations with distinct objectives • Adjunct information for anastomotic technique for colectomy is not specified -E.g. side-to-end, end-to-end -Specific root operation is assigned -With root operation Bypass for the anastomoses

  7. Myotomy • Myotomy -Esphagomyotomy– Index directs to Division of esophageal junction -Pyloromyotomy – no index entry • Dilation – to enlarge the diameter of tubular body part • Includes both intraluminal and extraluminal methods • Device placed to maintain new diameter is coded in the device value

  8. Other Procedures • Volvulus -Reposition of body part involved • Fixation procedures -E.g. Reposition -rectopexy, proctopexy, gastropexy • Enterolysis -Release of body part being freed -See Coding Guideline B3.13

  9. Body Parts • Upper Intestinal Tract -Above the diaphragm • Lower Intestinal Tract -Below the diaphragm • Esophagus -Upper or cervical -Middle or thoracic -Lower or abdominal • See Table 12.2

  10. Approaches • 0 – Open • 3 – Percutaneous • 4 - Percutaneous endoscopic • 7 – Via natural or artificial opening • 8 - Via natural or artificial opening endoscopic • X - External

  11. Devices • Intraluminal device, airway -Esophageal or gastric tube or obturator airways -Inserted through the mouth -Inflatable bulb blocks air entry and forces air into the trachea • Artificial anal sphincter -To restore bowel control -See Figure 12.5

  12. Qualifiers • Bypass -See Coding Guideline B3.6a- body part – bypassed from qualifier – bypassed to • Transfer • Transplantation • Diagnostic – X • No Qualifier - Z

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