AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 3; Ask the Editor

Cystogastrostomy with Stent Insertion

A patient diagnosed with walled off pancreatic necrosis and pancreatic pseudocyst adjacent to the stomach body, underwent endoscopic cystogastrostomy using the AXIOS™ Stent system. The endoscope was placed under direct vision, and the stomach wall and pancreatic pseudocyst were punctured under endosonographic guidance. An AXIOS™ stent was placed in close approximation to the walls of the cyst and the stomach through the cystogastrostomy. Dark brown fluid was drained from the stent. A gastroscope was advanced into the stomach under direct visualization, a wire was inserted through the AXIOS™ stent into the cyst cavity under fluoroscopic guidance, and a dilating balloon was then advanced over the wire with successful dilation of the tract. A large necrotic cavity was visualized, and a catheter was placed into the AXIOS™ stent under endoscopic and fluoroscopic guidance to maintain patency. What is the appropriate code assignment for cystogastrostomy using the AXIOS™ stent? Is it appropriate to report additional codes for balloon dilation of the tract and dilation of the AXIOS™ stent? If so, what are the correct code assignments? ...

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