This week we look at some highlights of Coding Clinic 3rd Quarter Volume 4 including a correction from an earlier version.

 

Correction Notice - Tunneled Vascular Access Catheter

A tunneled vascular access device is typically advanced via the internal jugular vein into the superior/inferior vena cava, or right atrium under fluoroscopic guidance. There was a misprint in Coding Clinic Fourth Quarter 2015, pages 30-31 which stated that a pocket is created in the chest wall subcutaneous tissue for the placement of a port for a tunneled hemodialysis catheter. Please use guidance stated in Coding Clinic Third Quarter Volume 4 Correction Notice for advice regarding the correct coding of this procedure.

Coding Clinic 3Q 2017 Vol 4, pg. 28

 

Bypass of Innominate Vein to Atrial Appendage

“Repair” is the default root operation for reporting the bypass from an innominate vein to any cardiac structure. Currently, there is not a unique code in ICD-10-PCS to report bypass from the innominate vein to any cardiac structure.

Coding Clinic 3Q 2017 Vol 4, pg. 15

 

Abdominal Aorta Debranching with Bypass of External Iliac Artery to Bilateral Renal Arteries and Superior Mesenteric Artery

Assign ICD-10-PCS code 041C0J5 Bypass Right Common iliac artery to bilateral renal artery with synthetic substitute, open approach and code 041C0J2 Bypass right common iliac artery to mesenteric artery with synthetic substitute, open approach when an abdominal aortic debranching with bypass from the right external iliac artery to right and left renal arteries and the superior mesenteric artery using Dacron grafts is documented. The common iliac artery is the closest qualifier equivalent in table 041 for the SMA and renal arteries.

Coding Clinic 3Q 2017 Vol 4, pg. 16