In ICD-10-PCS two codes are required to appropriately report a carotid endarterectomy with patch graft. This is a change from ICD-9-CM procedural coding as the patch graft was included in the endarterectomy code.
An example is given in AHA Coding Clinic, Second Quarter 2016, pages 11 & 12. A separate code is necessary to show placement (supplement) of the patch graft along with the code for the endarterectomy (extirpation). AHA Coding Clinic First Quarter 2016, page 131 also addresses coding extirpation to the body part that is furthest from the point of entry when the lesion being removed is continuous.
Definition of root operation Extirpation: Taking or cutting out solid matter from a body part.
Definition of root operation Supplement: Putting in or on biologic or synthetic material that physically reinforces and/or augments the function of a portion of a body part.
AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, Second Quarter 2016, Pages 11 & 12
AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, First Quarter 2016, page 131
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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
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