AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 1; Ask the Editor

Ex-Vivo Liver Tumor Resection and Autotransplantation

A 16-year-old with fibrolamellar hepatocellular carcinoma presented for resection of liver tumor. The main tumor was on the left side with extensive tumor thrombus in the portal vein. The patient also had a small lesion in the middle of the right lobe. In order to effectively remove the extensive left tumor thrombus and right lobe lesion, it was decided to perform the resection with ex vivo approach followed by autotransplantation. Prior to explantation, the major vessels including the major hepatic veins were clamped and the liver was subsequently removed and taken to the back table for the resection procedures. The liver was flushed and then submerged with cold histidine tryptophan ketoglutarate (HTK) solution. The tumors were resected and the liver was then flushed again and reimplanted into the patient. How is the explantation and subsequent reimplantation of the liver coded? Would it be appropriate to assign the root operation Transplantation to capture the complexity of the procedure? ...

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