Chapter Seven NS10_C07_P1
Chapter 7: Digestive System (40490-49999) Codes divided primarily by site, such as: Lips Mouth Intestines
E/M Same types of services as other physicians: Consultations Office visits Critical care
External Procedures Performed with or without scope (e.g.,anoscope) Figure: 7.4
Hemorrhoid Grading Grade I projects into anal canal Figure: 7-5 Grade I projects into anal canal Grade II protrudes from anus, returns spontaneously Grade III protrudes from anus, must be manually returned Grade IV is permanently produced
Open, Laparoscopic, and Endoscopic Procedures Open (site open to view) Surgical incision Endoscopic (through mouth or anus) Laparoscopic (percutaneously) Figure: 7-8
Endoscopic Procedures Code to the furthest extent of the procedure Documented in the operative report Code choice based on type and extent of procedure
Endoscopic Measurement Anoscopy: up to 5 cm Proctoscopy: 6-25 cm Flexible sigmoidoscopy: 26-60 cm Colonoscopy: Greater than 60 cm Figure: 7-6
Hernia (49491-49611) Protrusion of tissue or organ through abdominal wall Strangulated Cuts off from blood supply Incarcerated Cannot be returned to original location Codes divided based on: Initial or recurrent Strangulated or incarcerated
Hemic/Lymphatic (38100-38999) Hemic: Blood cells and bone marrow Lymphatic: Body’s drainage system Codes report: Spleen General Lymph nodes
Diaphragm (39501-39599) Includes diaphragmatic hernia repair (39502-39531) Repair of laceration
Conclusion