Ravitch repair of pectus excavatum--Which root operation??

morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu
in Pediatrics

Hi Guys,

We had a patient who underwent a Ravitch repair of a pectus excavatum and I am getting confused on the correct root operation. I originally thought reposition and that's where 3M takes you when you enter Ravitch, but when 3M CAC autosuggested the PCS code it uses supplement. Oddly enough, reposition takes you to DRG 983 Extensive OR procedure unrelated to PDX but supplementation does not. I can see where both root operations could be applicable and wonder if both are needed.

Anyone who has more expertise with these please chime in! We have an increase in these during the summer since kids are out of school and this is our first round of coding them in ICD-10 PCS.

Thanks in Advance,

Jeff

Comments

  • cmclose@saintfrancis.comcmclose@saintfrancis.com

    I haven't dealt with this yet Jeff but am very interested in the answer! I would think Supplement without further research. (I assume Ravitch involves using a device.)

    Great question!!!

  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    Thanks Karen! I was about to submit it to Nosology but will research if it's going to be "fixed" with the next update. It does help a lot!

    Jeff

  • lnsavage10@yahoo.comlnsavage10@yahoo.com

    Thank you!!!! I just had one of these and could not figure it out :)


    Leah

  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu
    Well, I just received an email from 3M Nosology & they state the correct root operation should be reposition & they will be updating the software in 6-8 weeks!  So now they've given two different answers! 

    Root operation ion reposition makes the DRG Ext op procedure unrelated to PDX but supplementation keeps you in the chest procedure DRG. 

    I'm totally confused now!!
    jeff
  • cmclose@saintfrancis.comcmclose@saintfrancis.com
    Thanks Karen!
  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu
    Karen, It's definitely interesting they told us two different answers. I don't know why I didn't think about checking coding clinic  :pensive: . After discussing on here, we sent it off to an external review & i just found out they returned it stating supplement was correct. Definitely goes to show that PCS is open to interpretation!

    Hoping the DRG will get straightened out since it's definitely not a procedure unrelated to the PDX (in my opinion).

    i love CDI Talk, put enough CDI's together & we could solve the worlds problems, lol

    Jeff
  • hillsandovals@email.chop.eduhillsandovals@email.chop.edu

    Hi Jeff, I have found that 3M can take you down the wrong path in many cases. We have started to use the CMS PCS table which is more accurate. In many cases, when you finish piecing together the puzzle, the table gives you the correct answer, it is just really reading the OP note carefully.

    hope this helps.

    Steph

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