AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Quarter 3; Ask the Editor
Creation of Indiana Pouch
A patient underwent a simple cystectomy with creation of an Indiana pouch. During the procedure, dissection of the bladder was carried out. The ascending colon and ileum were divided and sutured creating a pouch, and the bowel was reanastomosed. The right ureter was tunneled through the bowel creating an ureterocolonic anastomosis, and a urinary diversion stent was passed into the patient’s right kidney. Through a separate incision, the left ureter was placed into the pouch and an additional urinary diversion stent was passed into the patient’s left renal pelvis. Prior to complete closure of the pouch a suprapubic catheter was placed and the bilateral ureteral stents were withdrawn from the lumen of the pouch. The remainder of the pouch was closed and a catheterizable stoma was created at the abdominal wall. What are the appropriate ICD-10-PCS code assignments for creation of an Indiana pouch and stoma following a cystectomy? ...
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Article Overview
This premium article discusses how to approach ICD-10-PCS assignment for a urinary diversion case involving cystectomy and creation of an Indiana pouch with a catheterizable stoma. It is aimed at inpatient coding professionals, auditors, CDI specialists, and others who code complex urologic and bowel-related operative reports. The article focuses on interpreting the operative sequence, identifying the major procedures involved, and determining the appropriate ICD-10-PCS codes for the diversion and stoma work described.
Why This Topic Matters
Complex urinary diversion cases often involve multiple operative steps across different body systems, making code assignment dependent on careful reading of the operative note. This article helps readers evaluate the procedure scope and understand how the case is framed for ICD-10-PCS selection.
What You Will Learn
- How a urinary diversion case is described in operative documentation
- How the article frames ICD-10-PCS code assignment for a post-cystectomy pouch procedure
- How multiple operative components are presented for coding review
- How to interpret the documentation at a high level for inpatient procedure coding
Who Should Read This
- Hospital inpatient coders
- Coding auditors
- CDI specialists
- Health information management professionals
- Urologic surgery coding staff
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