Wednesday, December 21, 2016

ICD-10-PCS Practice charts


ICD-10-PCS Practice Case Scenarios

Case 1:

Preoperative Diagnosis: Extensive laceration, distal left index finger with partial severance of distal phalanx

Postoperative Diagnosis: Same

Operation: Open reduction internal fixation distal phalanx L index finger with Kirschner wire stabilization; nonexcisional debridement of laceration of L index finger; repair laceration
L middle finger

Procedure: Pt prepped & draped in the usual manner after axillary block administered. Pt had a Miter saw go into his index finger, lacerating the dorsal radial aspect of index finger at distal phalangeal phalanx level. Saw went into base of nail. We used C-arm fluoroscopy to thoroughly evaluate area & then inflated tourniquet to 280 mm of Mercury after arm exsanguinated. Wound thoroughly irrigated w/saline solution to which antibiotics were added & subcutaneous tissue debrided of all devitalized tissue, trash, & foreign bodies present in tissue. Then used Kirschner wire of 0.045 inches in dia. & drilled across fracture site in joint to totally stabilize area. Once this in place, then very carefully closed skin w/ interrupted running 5-0 Ethibond suture. Area of laceration on middle finger just distal to insertion of extensor tendon. Looked like bulk of nail bed would be viable, some damage to base of nail bed. Laceration of left middle finger, which extended into subcutaneous tissue, then repaired w/ 4-0 Vicryl sutures. Large compression dressing applied.

0PSV04Z Reposition, Phalanx, Finger, Left  (0PSV) In Index
Reduction, Fracture, see Reposition

0JQK0ZZ Repair, Subcutaneous Tissue and Fascia, Hand, Left (0JQK)
 Suture, Laceration repair, see Repair

***If a procedure is performed on a portion of a body part that does not have a separate body part value, code the body part value corresponding to the whole body part***






Case 2:

Preoperative Diagnosis:  Left upper eyelid laceration & chin laceration

Postoperative Diagnosis: Same

Operation: Repair of L upper eyelid & chin lacerations

Procedure: After patient suitably prepared under general anesthesia, left upper eyelid & chin were dressed & draped with Betadine. Left upper eyelid laceration (3 cm) inspected. It did appear to go through left upper eyelid canaliculus. Distal end could be seen, proximal end could not. It was elected not to try to repair canaliculus. One interrupted 6-0 silk suture placed through lid margin & then 3 interrupted 5-0 Vicryl sutures placed through deep tissue. Running 6-0 silk suture then placed through skin. 2.0 cm chin laceration of skin closed w/three interrupted 6-0 silk sutures. Gentamicin ointment applied to lacerations and dressing placed
over left eye. Patient tolerated procedure well & left OR in stable condition.

08QPXZZ Repair, Eyelid, Upper, Left (08QP)
Suture, Laceration repair, see Repair

0HQ1XZZ Repair, Skin, Face (0HQ1XZZ)

***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 are also not coded separately.

Example: Resection of a joint as part of a joint replacement procedures is included in the root operation definition of replacement and is not coded separately. Laparotomy performed to reach the site of an open liver biopsy is not coded separately.***

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