This page addresses follow-up questions and additional information pertinent to our webinar
Defining Detachment.
** 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:  Can you address coding for guillotine amputation followed by definitive amputation days later? Is this coded as two different amputations or as an amputation for stage 1 and closure for stage 2?
A:  Guillotine amputation is a staged procedure in which the infected portion of the bone is removed without flap closure. It is reported with the root operation Detachment. The definitive amputation procedure follows days later and is also coded to the root operation Detachment.

Q:  How is Chopart amputation coded when there is removal of some, but not all, of the tarsals?
A:  Use the root operation Detachment with the body part for foot (right or left) and the qualifier Complete. Whether the foot is amputated at the TMT joint or midtarsal joint, it is still considered a complete foot amputation. Do not assign additional codes for removal of the tarsal bones. This is consistent with advice published in Coding Clinic, First Quarter 2017, page 22.

Q:  Which bones compose the forefoot, midfoot, and hindfoot?
A:  The metatarsals make the forefoot, or front of the foot. The hindfoot is the back part of the foot composed of two large tarsals: the calcaneus and talus. The midfoot is composed of the other tarsals, namely: navicular, cuboid, medial cuneiform, intermediate cuneiform, and lateral cuneiform.

Looking for additional information on this topic?

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

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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