1. Chapter Seven
NS10_C07_P1

2. Chapter 7: Digestive System (40490-49999)
Codes divided primarily by site, such as:
Lips
Mouth
Intestines

3. E/M Same types of services as other physicians: Consultations
Office visits
Critical care

4. External Procedures Performed with or without scope (e.g.,anoscope)
Figure: 7.4

5. 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

6. Open, Laparoscopic, and Endoscopic Procedures
Open (site open to view)
Surgical incision
Endoscopic (through mouth or anus)
Laparoscopic (percutaneously)
Figure: 7-8

7. Endoscopic Procedures
Code to the furthest extent of the procedure
Documented in the operative report
Code choice based on type and extent of procedure

8. Endoscopic Measurement
Anoscopy: up to 5 cm
Proctoscopy: cm
Flexible sigmoidoscopy: cm
Colonoscopy: Greater than 60 cm
Figure: 7-6

9. Hernia ( )
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

10. Hemic/Lymphatic (38100-38999) Hemic: Blood cells and bone marrow
Lymphatic: Body’s drainage system
Codes report:
Spleen
General
Lymph nodes

11. Diaphragm ( )
Includes diaphragmatic hernia repair ( )
Repair of laceration

12. Conclusion