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AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 3; Ask the Editor

Pancreatic Pleural Fistula

A patient was admitted for management of a pancreatic pleural fistula and left pleural effusion. The patient is status post tumor debulking surgery, including splenectomy and distal pancreatectomy for appendiceal cancer. During this admission, the pleural effusion was drained. The provider noted, “high amylase level consistent with pancreatic pleural fistula.” ICD-10-CM does not provide a specific index entry for pancreatic pleural fistula; however, pleural fistula is indexed to code J86.0, Pyothorax with fistula. What (is)/are the appropriate code assignment(s) for a pancreatic pleural fistula? Additionally, would it be reasonable to query for postprocedural fistula given the patient’s surgical history of tumor debulking with splenectomy and distal pancreatectomy? ...

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