Answer key chapter 1



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ANSWER KEY
Chapter 1
2013 Updates
All dates that indicate an October 1, 2013 implementation date should be changed to state October 1, 2014.

Test Your Knowledge




  1. C

3. D

5. A
Code Building

1.

1.1 This is a resection, as the complete body part, the gall bladder is removed. The definition for the root operation removal involves taking out a device from a body part.



1.2 Resection, gallbladder

1.3 0FT


1.4 4—gallbladder

1.5 4—percutaneous endoscopic

1.6 Z and Z for No Device and No Qualifier

1.7 0FT44ZZ




Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier

Medical and Surgical



Hepatobiliary System and Pancreas



Resection


Gallbladder


Percutaneous Endoscopic


No device


No qualifier



0

F

T

4

4

Z

Z

3.


3.1 The main term orchiopexy has two cross references: see Repair, Male Reproductive System and see Reposition Male Reproductive System

3.2 Because the objective of the procedure is to place the undescended testicles into their proper spot, the correct root operation, Reposition—moving to its normal location, or other suitable location, all or a portion of a body part, is selected

3.3 Reposition, Male Reproductive System

3.4 0VS


3.5 C for bilateral as the clinical documentation states testicles

3.6 0 for Open

3.7 Z and Z for No Device and No Qualifier

3.8 0VSC0ZZ




Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier

Medical and Surgical



Male Reproductive System



Reposition


Testis, Bilateral


Open

No device

No qualifier



0

V

S

C

0

Z

Z



Chapter 2
2013 Updates
Coding Guideline A5 on page 31 updated. The last sentence now reads “Example: In the Lower Joints body system, the device value 3 in the root operation Insertion specifies Infusion Device and the device value 3 in the root operation Replacement specifies Ceramic Synthetic Substitute.”
Coding Guideline B3.1b on page 35 updated. The Guideline now reads:

“Components of a procedure specified in the root operation definition and explanation are not coded separately. Procedural steps necessary to reach the operative site and close the operative site, including anastomosis of a tubular body part, are also not coded separately.”


Also, in this Guideline there is a sentence added to the Example that reads: “In a resection of sigmoid colon with anastomosis of descending colon to rectum, the anastomosis is not coded separately.”
New Coding Guideline B4.8 to be added on page 46
B4.8

In the Gastrointestinal body system, the general body part values Upper Intestinal Tract and Lower Intestinal Tract are provided as an option for the root operations Change, Inspection, Removal and Revision. Upper Intestinal Tract includes the portion of the gastrointestinal tract from the esophagus down to and including the duodenum, and Lower Intestinal Tract includes the portion of the gastrointestinal tract from the jejunum down to and including the rectum and anus.



Example: In the root operation Change table, change of a device in the jejunum is coded using the body part Lower Intestinal Tract.

Substitute the following Approach Decision Tree for Figure 2.5 on page 46







© Kuehn Consulting, LLC. Used with permission.


Answer Key
Check Your Understanding
1. c (B5.3a)

3. c (B3.4)

5. c (A9)

7. b (B3.10c)

9. c (B2.1b)
Case Studies
Case 1


  1. a. Resection. Rationale: see Guideline B3.8—the entire body part is taken out

b. 2 the laparoscopic cholecystectomy and the liver biopsy

c. 0FT44ZZ, 0FB04ZX



Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier

Medical and Surgical

Hepatobiliary

System and Pancreas


Resection

Gallbladder

Percutaneous Endoscopic

No Device

No Qualifier

0

F

T

4

4

Z

Z




Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier

Medical and Surgical

Hepatobiliary

System and Pancreas


Excision

Liver

Percutaneous Endoscopic

No Device

Diagnostic

0

F

B

0

4

Z

X

Case 3
a. 2

b. 0CBV8ZZ, 0CBT8ZZ

Rationale: See the Index main term Excision, subterms Vocal Cord, Left, Vocal Cord, Right




Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier

Medical and Surgical

Mouth and Throat


Excision

Vocal Cord, Left

Via Natural or Artificial Opening, Endoscopic

No Device

No Qualifier

0

C

B

V

8

Z

Z




Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier

Medical and Surgical

Mouth and Throat


Excision

Vocal Cord, Right

Via Natural or Artificial Opening, Endoscopic

No Device

No Qualifier

0

C

B

T

8

Z

Z

c.
B3.2.a—multiple procedures are coded if the same root operation is performed on different body parts as defined by distinct values of the body part character.


B3.11a—Inspection of a body part(s) performed in order to achieve the objective of a procedure is not coded separately.


Chapter 3
2013 Updates
There are no 2013 updates for Chapter 3
1. b

3. c


5. b

7. d


Which Root Operation Is It?


  1. Root Operation: Resection

ICD-10-PCS Code: 0FT20ZZ


Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical



Hepatobiliary System and Pancreas



Resection


Liver, Left Lobe


Open


No Device


No Qualifier

0

F

T

2

0

Z

Z

3. Root Operation: Extirpation

ICD-10-PCS Code: 0TC43ZZ


Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical



Urinary System


Extirpation


Kidney Pelvis, Left


Percutaneous


No Device


No Qualifier

0

T

C

4

3

Z

Z

5. Root Operation: Extraction

ICD-10-PCS Code: 07DR3ZX


Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical



Lymphatic and Hemic Systems



Extraction


Bone Marrow, Iliac


Percutaneous


No Device


Diagnostic

0

7

D

R

3

Z

X

7. Root Operation: Destruction

ICD-10-PCS Code: 015C3ZZ


Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical



Peripheral Nervous System



Destruction


Pudendal Nerve


Percutaneous


No Device


No Qualifier

0

1

5

C

3

Z

Z

9. Root Operation: Fragmentation

ICD-10-PCS Code: 0TF78ZZ


Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical


Urinary System


Fragmentation


Ureter, Left


Via Natural or Artificial Opening, Endoscopic



No Device


No Qualifier

0

T

F

7

8

Z

Z


Chapter 4
2013 Updates
There are no 2013 updates for Chapter 4

Check Your Understanding




  1. b

3. a

5. c


7. c

9. d
Which Root Operation Is It?




  1. Root Operation: Release

ICD-10-PCS Code: 0DN34ZZ

Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical



Gastrointestinal

System


Release


Esophagus, Lower


Percutaneous

Endoscopic


No Device

No Qualifier

0

D

N

3

4

Z

Z

3. Root Operation: Reposition

ICD-10-PCS Code: 0MSN4ZZ

Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical



Bursae and Ligaments



Reposition


Knee Bursae and Ligaments, Right



Percutaneous

Endoscopic


No Device


No Qualifier

0

M

S

N

4

Z

Z

5. Root Operation: Transfer

ICD-10-PCS Code: 01X50Z4

The Anterior Interosseous nerve is not listed under the main term Transfer, Nerve. See the Body Part Index and/or the Index under the Anterior Interosseous Nerve, use Nerve, Median.



Section

Body System

Root Operation

Body Part

Approach

Device

Qualifier


Medical and Surgical


Peripheral Nervous

System



Transfer


Median Nerve


Open


No Device


Ulnar

Nerve

0

1

X

5

0

Z

4

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