Root Operations Group 5

1
Root Operations Group 5

• Presented by
• THIMA ICD 10 Committee

2
Altering the diameter or root of a tubular body
part
3
Bypass

• Altering the route of passage of the contents of
  a tubular body part

Image Debakeydepartmentofsurgery.org
4
Coding Guideline B3.6a

• Bypass procedures are coded by identifying the
  body part bypassed from and the body part
  bypassed to.
• The fourth character body part specifies the body
  part bypassed from, and the qualifier specifies
  the body part bypassed to.

5
Your Turn to Practice

1. Bypass from stomach tojejunum, stomach is the ?
   and jejunum is the ?
2. What is the qualifier for a colostomy?
3. What would make the term esophagoenterostomy
   difficult to code?

6
Coding Guideline B3.6b

• Coronary arteries are classified by number of
  distinct sites treated, rather than number of
  coronary arteries or anatomic name of a coronary
  artery (e.g., left anterior descending).
• Coronary artery bypass procedures are coded
  differently than other bypass procedures as
  described in the previous guideline.
• Rather than identifying the body part bypassed
  from, the body part identifies the number of
  coronary artery sites bypassed to, and the
  qualifier specifies the vessel bypassed from.

7
Coding Guideline B3.6c

• If multiple coronary artery sites are bypassed, a
  separate procedure is coded for each coronary
  artery site that uses a different device and/or
  qualifier.

8
Coding Guideline B3.9

• If an autograft is obtained from a different body
  part in order to complete the objective of the
  procedure, a separate procedure is coded.

9
Does anterior resection of rectum with
synchronous colostomy require one code or two?
10
Dilation

• Expanding an orifice or the lumen of a tubular
  body part

Image yalemedicalgroup.org
11
Coding Guideline B4.4

• The coronary arteries are classified as a single
  body part that is further specified by number of
  sites treated and not by name or number of
  arteries.
• Separate body part values are used to specify the
  number of sites treated when the same procedure
  is performed on multiple sites in the coronary
  arteries.

12
Occlusion

• Completely closing an orifice or the lumen of a
  tubular body part

Image Medline Plus
13
Restriction

• Partially closing an orifice or the lumen of a
  tubular body part

Image yalemedicalgroup.org
14
Your Turn to Practice
15
Gastrojejunostomy
Bypass
Image Debakeydepartmentofsurgery.org
16
Laparoscopic vertical sleeve gastrectomy
Excision
Image Vanderbilthealth.com
17
Gastric banding
Restriction
Image MedlinePlus
18
Suture ligation of failed AV graft
Occlusion
Image http//kidney.niddk.nih.gov
19
Ventriculoperitoneal shunt
Bypass
Image MedlinePlus
20
My wheels are turning, I think Im getting
it!!!!!!!
ICD 10 makes no sense?????
Your brain on I-10
Your brain on I-9