Health Information Management

Q&A: Coding for eponyms in ICD-10-PCS

JustCoding News: Inpatient, April 25, 2012

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QUESTION: How will we be able to code for procedures such as Billroth procedures, Roux-en-Y anastomoses, and Whipple’s procedure when eponyms won’t be used in ICD-10-PCS?

ANSWER:
This is one area where it’s important to get a head start before ICD-10-CM/PCS implementation and beef up your knowledge of how an actual procedure is performed and what steps are involved. Remember the focus in ICD-10-PCS is on the objective of the procedure. So learn whether physicians are removing a portion of a body part or are removing a portion of a body part and then possibly bypassing the same body part.

Some procedures may actually require more than one code when you look at the objective of the procedure being performed.

Look for a good reference source that provides the definitions of the eponym procedures. Also consider asking your physicians to explain what is involved the procedure. Most physicians love to provide education about procedures.

You definitely want to start learning the procedures because ICD-10-PCS will not cross reference the eponyms. So if a physician documents a McBride’s bunionectomy, you need to know what the procedure entails. You can also ask your physicians to explain the procedure to you.

Even though the ICD-10-PCS guidelines state that the physician does not have to reference a specific root operation in the operative report, the guidelines also indicate that if the coder can’t determine the objective of the procedure, they can query the physician.

Editor’s Note: Jennifer Avery, CCS, CPC-H, CPC, CPC-I, senior regulatory specialist with HCPro, Inc., in Danvers, Mass., answered this question during the February 29-March 2 “JustCoding Virtual Summit: ICD-10-CM and ICD-10-PCS.”

This answer was provided based on limited information that was submitted to JustCoding.com. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

Need expert coding advice? Submit your question to Senior Managing Editor Michelle Leppert, CPC-A, at
mleppert@hcpro.com, and we’ll do our best to get an answer for you.
 



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