Health Information Management

ICD-10 tip: ICD-10-PCS root operation change will do you good

HIM-HIPAA Insider, April 1, 2013

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We all know that procedure coding will change considerably on October 1, 2014 with the implementation of ICD-10-PCS. But what about change as an ICD-10-PCS root operation?

In ICD-10-PCS, you will use the root operation change for procedures that involve:
•    Removing a device then immediately inserting a similar device
•    Exchanging  the device without making an incision or puncturing the skin or mucous membrane

So, if the physician removes a patient’s percutaneous endoscopic gastrostomy (PEG) tube and immediately inserts a new one, report 0D20XUZ (change feeding device, upper intestinal track, external approach).

A change procedure always involves a device, but you need to make sure you are coding the correct device. For a change involving the upper intestinal track, we have three device possibilities:
•    0, drainage device
•    U, feeding tube
•    Y, other device

The approach for a change procedure is always external.
Other change procedures include:
•    0S2YX0Z, exchange of drainage tube from right hip joint (the body part for this code is very general—simply lower joint, so regardless of which joint is involved, you’ll report this code)
•    0B21XFZ, tracheostomy tube exchange
•    0W29X0Z, Change chest tube for right pneumothorax
•    0020X0Z, exchange of cerebral ventriculostomy drainage tube
•    0T2BX0Z, foley urinary catheter exchange (the device is a drainage tube because a foley catheter drains urine)

This article originally appeared on the ICD-10 Trainer blog.

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