Presented by:THIMA ICD 10 Committee

Operation Action Target Clarification

Example

Insertion –(H) Putting in Device in or on a body part

Does not physically take the place of a body part

Pacemaker insertion

Replacement – (R) Putting in or on Biological 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 on Biological 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 off Device from a body part

N/A Cardiac 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) Correcting Malfunctioning 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 02H72. Go to table 02H with body part 7 (atrium, left)3. Approach - Percutaneous -34. Device – Cardiac Lead Pacemaker – J5. Qualifier – Z – No qualifier6. 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 insertionof total knee prosthesis

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1. Replacement, joint, knee left 0SRD2. Go to table 0SR with body part D (knee joint,

left)3. Approach – open – 04. Device – synthetic substitute – J5. Qualifier – uncemented – A6. 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 rightinguinal hernia repair with Marlex mesh

Taking out or off a device from a body part

Example: Removal of an endotracheal tube

A. Upper arteriesB. Heart and great vessels

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Example: Removal of Swan Ganz catheter from right pulmonary artery

Body part is Y – Great Vessel

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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

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Casting of nondisplaced fracture

Reduction of displaced fracture

Putting a pin in a nondisplaced fracture

Immobilization Insertion Reposition

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23Image: breastcancer.org

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25Image: mayoclinic.org

26Image: urogyn-nj.com

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