Chemoembolization
Hi All,
At my hospital we are having discussions over the root word for chemo-embolization . The patient is s/p TACE procedure. Coding believes it is Introduction and CDI believes occlusion. What do your facilities use ? and can you provide me with literature to present ?
At my hospital we are having discussions over the root word for chemo-embolization . The patient is s/p TACE procedure. Coding believes it is Introduction and CDI believes occlusion. What do your facilities use ? and can you provide me with literature to present ?
Comments
Coding Clinic, Third Quarter 2014: Page 26
Coding advice or code assignments contained in this issue effective with discharges September 15, 2014.
Question:
A 60-year-old patient with cirrhosis and hepatocellular carcinoma underwent multiple coil embolizations of the gastroduodenal artery, and chemoembolization of the 4 B arterial branch segments off the right hepatic artery with a mixture of mitomycin, doxorubicin, and lipiodol, followed by particle embolization with 100-300 microspheres. What are the correct ICD-10-PCS codes for the coil embolizations of the gastroduodenal artery, and chemoembolization of the hepatic artery, followed by embolization with microspheres?
Answer:
The Body Part Key of ICD-10-PCS instructs the coder to "use hepatic artery," for gastroduodenal artery, and the Device Key of ICD-10-PCS instructs the coder that intraluminal device "includes embolization coil(s)." Embolization microspheres are likewise coded as intraluminal device when used to occlude a tubular body part. The embolization procedure is coded twice, because the gastroduodenal and hepatic arteries are different body sites and are both included in the hepatic artery body part value. According to multiple procedures guideline B3.2b, multiple procedures are coded if:
The same root operation is repeated at different body sites that are included in the same body part value.
Assign the following ICD-10-PCS codes:
04L33DZ
Occlusion of hepatic artery with intraluminal device, percutaneous approach
04L33DZ
Occlusion of hepatic artery with intraluminal device, percutaneous approach
3E05305
Introduction of other antineoplastic into peripheral artery, percutaneous approach
Denise