AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 1; Ask the Editor

Bleeding from Thyroid Bed Following Thyroidectomy

A patient underwent hemithyroidectomy for a neoplasm of the thyroid gland. After noticing bleeding in the post-operative wound drain, the provider suspected a hematoma and a bleeding vessel. After reopening the patient, a pulsatile vessel was discovered at the inferior aspect of the thyroid bed, which was clamped and tied. The surgeon documented, “Complication: bleeding from the left inferior thyroid bed, while the patient was in the operating room.” When assigning a code for the bleeding, is it appropriate to report a code for the bleeding organ/structure or the bleeding blood vessel? ...

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