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By definition, a second degree perineal laceration involves rupture or tearing of the perineal muscle(s). Would physician documentation stating, “Second degree perineal laceration repair” be su...
A second deg...
A patient underwent a repeat low transverse cesarean section. During the cesarean delivery, vacuum extraction was used to assist with the delivery of the infant. What is the correct ICD-10-PCS qual...
Vacuum assis...
The patient was taken to the operating room post vaginal delivery for control of bleeding using a Bakri balloon. We are unsure if the Bakri balloon is coded to the Obstetrics section or the Medical...
The root ope...
How is an open posterior colporrhaphy/rectocele repair coded in PCS? Should one or two codes be assigned for this procedure?
...In the conte...
What is the appropriate ICD-10-PCS code, when a combination of drugs is administered during a single injection (e.g., corticosteroid and local anesthetic)?
...If two subst...
We are requesting that the Coding Clinic Editorial Advisory Board revisit advice published about non-Candida albicans sepsis. The Alphabetic Index under the term “Sepsis, candida,” directs to c...
Coding C...
Coding Clinic, Second Quarter 2013, advised the assignment of codes that describe the destruction of the right and left pulmonary veins (025T3ZZ and 025S3ZZ), for catheter ablation around ...
Upon further...
A 12-year-old patient presents to the emergency department (ED) after a car accident. She was a passenger in a car that was hit from the side by a sport utility vehicle (SUV), and the patient susta...
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The above patient returns three days later for a wound check with the pediatrician. The pediatrician only inspected the wounds. The wounds were found to be healing nicely, and no other intervention...
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The same patient now presents to the pediatrician’s office for suture removal. The pediatrician checks the wounds and removes sutures from both the scalp and cheek. Should code Z48.02, Encounter ...
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