AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2022 Issue 1; Ask the Editor

Insertion, Removal and Replacement of Endoluminal Vacuum Application

A patient was admitted and underwent a mediastinal washout and endoluminal vacuum application (EVAC) utilizing an endosponge, due to a near complete esophagogastric anastomotic disruption. Under direct endoscopic visualization, a gastroscope was advanced through the oropharynx into the esophagus identifying the location of the previous anastomosis. Posteriorly, there was an ulcer base and gastric mucosa located near the esophageal mucosa but the remainder of the anastomosis demonstrated a wide gap. Because of this large gap, essentially in the patient’s mediastinal cavity, there were large amounts of contamination and purulent material, which was suctioned and evacuated via the scope. The scope was then advanced down to the third portion of the duodenum with no relevant findings. The surgeon elected to place an endoluminal endosponge to assist in cleaning up the contamination. What is the ICD-10-PCS code assignment for the initial insertion of the EVAC? ...

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