Presented by: THIMA ICD 10 Committee

OperationActionTargetClarificationExample Insertion –(H)Putting inDevice in or on a body part Does not physically take the place of a body part Pacemaker insertion Replacement – (R)Putting in or onBiological or synthetic material; or living tissue taken from same individual Physically takes the place of all or a portion of a body part Total hip replacement Supplement- (U)Putting in or onBiological or synthetic material; or living tissue taken from same individual Physically reinforces or augments a body par Herniorrhaphy with mesh Removal – (P)Taking out or offDevice from a body part N/ACardiac pacemaker removal Change – (2)Taking out or off and putting back Identical or similar device in or on a body part Without cutting or puncturing skin or mucous membrane Drainage tube change Revision – (W)CorrectingMalfunctioning or displaced device in or on a body part To the extent possible Hip prosthesis adjustment

Putting in a non-biological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part. Example: Percutaneous placement of pacemaker lead into the left atrium

1.Insertion of device, atrium, left 02H7 2.Go to table 02H with body part 7 (atrium, left) 3.Approach - Percutaneous -3 4.Device – Cardiac Lead Pacemaker – J 5.Qualifier – Z – No qualifier 6.02H73JZ

Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part Example: Total left knee arthroplasty with insertion of total knee prosthesis

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1.Replacement, joint, knee left 0SRD 2.Go to table 0SR with body part D (knee joint, left) 3.Approach – open – 0 4.Device – synthetic substitute – J 5.Qualifier – uncemented – A 6.0SRD0JA

Putting in or on biologic or synthetic material that physically reinforces and/or augments the function of a portion of a body part Example: Laparoscopic right inguinal hernia repair with Marlex mesh

1. Supplement, inguinal region, right 0YU5 2. Go to table 0YU with body part 5 (inguinal region, right) 3. Approach - percutaneous endoscopic Device - Synthetic substitute – J 5. Qualifier - No qualifier – Z 6. 0YU54JZ

Taking out or off a device from a body part Example: Removal of an endotracheal tube

A. Upper arteries B. Heart and great vessels 11

Example: Removal of Swan Ganz catheter from right pulmonary artery Body part is Y – Great Vessel 12

Removal device from trachea 0BP1 Go to table 0BP with body part 1 (trachea) Approach - External – X Device – endotracheal device – E Qualifier – no qualifier – Z 0BP1XEZ

Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without cutting or puncturing the skin or a mucous membrane. Example: Tracheostomy tube exchange

Change, by device, tracheostomy device, trachea 0B21 Go to table 0B2 with body part 1 (trachea) Approach – external – X Device – tracheostomy device – F Qualifier – no qualifier – Z 0B21XFZ

Correcting, to the extent possible, a malfunctioning or displaced device Example: Open revision of left hip replacement, with adjustment of the prosthesis

Revision of device in, joint, hip, left 0SWB Go to table OSW with body part B (hip joint, left) Approach – open – 0 Device – synthetic substitute – J Qualifier – no qualifier - Z 0SWB0JZ

Practice Review the exercises and match the root operations to procedures Continue to practice, practice, and more practice to help you master procedure coding involving one of these devices 18

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Casting of nondisplaced fracture Reduction of displaced fracture Putting a pin in a nondisplaced fracture Immobilization Insertion Reposition 20

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23 Image: breastcancer.org

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25 Image: mayoclinic.org

26 Image: urogyn-nj.com

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