AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Quarter 4; New/Revised ICD-10-PCS Procedure Codes
Dilation and Bypass of Cerebral Ventricle
An infant diagnosed with hydrocephalus and syringomyelia with obstructed endoscopic third ventriculostomy (ETV) was admitted for reopening of the ETV. The previous incision was opened, the dura was incised, a catheter was placed into the ventricle and pressure was measured. The catheter was removed and a ventriculoscope was passed into the lateral ventricle along the same tract. The floor of the third ventricle had scarred over, completely obstructing the previous ETV. This was reopened with a wire and dilated with a Fogarty balloon catheter. An underlying membrane was found and this was penetrated and widened with a Fogarty balloon catheter. The provider elected to also perform an opening through the lamina terminalis with the wire and enlarge it with a Fogarty balloon catheter into subarachnoid space. The endoscope was withdrawn, the dura was closed and the burr hole area was sealed. What is the correct procedure code for the reopening of the endoscopic third ventriculostomy? Is the dilation of the opening with Fogarty balloon catheter a separate procedural objective; therefore meeting the multiple procedure guideline? ...
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Article Overview
This article reviews ICD-10-PCS changes related to procedures on the cerebral ventricle, with emphasis on how the code tables were updated and how those updates relate to a clinical scenario involving reopening an endoscopic third ventriculostomy. It is relevant to facility coders, ICD-10-PCS specialists, and clinical documentation teams who need to understand the scope of the code-set revision and the type of procedure context discussed.
Why This Topic Matters
These updates affect how cerebral ventricle procedures are represented in ICD-10-PCS and may influence coding for neurosurgical cases involving ventricular dilation or bypass-related approaches. Understanding the scope of the table changes helps coders recognize when a case falls within the revised code structure.
What You Will Learn
- What ICD-10-PCS change is being introduced for cerebral ventricle procedures
- How the article frames updates to cerebral ventricle bypass coding
- How the clinical scenario relates to the code-set update being discussed
- What type of procedure question the article is addressing
Who Should Read This
- Inpatient hospital coders
- ICD-10-PCS coding specialists
- Health information management professionals
- Clinical documentation improvement staff
- Neurosurgery coding staff
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