This page addresses follow-up questions and additional information pertinent to our webinar
ICD-10-PCS Procedural Coding On an After April 1 2024.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: If a patient undergoes a GammaTile procedure, which radioactive element should be reported?
A: GammaTile is the technology, which can use various types of radioactive elements. Coders should review chart documentation carefully and pay close attention to the radioactive element being used in a particular case to ensure proper reporting.
Q: It’s been drilled into us that repair with a device codes to the root operation Supplement rather than Repair. If the omentum is used for a Graham patch in repairing a perforated stomach, why is the root operation Repair rather than Supplement?
A: The repair of the stomach is performed using sutures, which is not a device. The Graham patch is acting as a support next to the sutures and is inherent to the procedure.
Q: There are codes for percutaneous arteriovenous fistula creation in both the X2K (New Technology Bypass) and 031 (Upper Arteries Bypass) tables. What is the difference between these two tables?
A: The codes in table X2K include procedures for bypassing the radial arteries using thermal energy resistance as the method of anastomosis. This code was created to report the Ellipsys procedure, where the radial artery is anastomosed to an adjacent vein using thermal resistance energy. Coding Clinic advises using a code from table 031 of the Ellipsys device is placed in the brachial artery, however, the manufacturer website does not state that the brachial artery is ever used in this procedure. In a similar technology, the WavelinQ device creates a percutaneous arteriovenous fistula using radiofrequency energy. The WavelinQ procedure anastomoses either the radial artery or brachial artery to an adjacent vein. It is Haugen’s recommendation to use codes in table X2K for the Ellipsys procedure and codes in table 031 for the WavelinQ procedure.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Director of Coding Quality & Education
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
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