EmailAdhesions due to surgery
Publication Date: June 2014
ICD 10 AM Edition: Eighth edition
Retired Date: 30/6/2020
Query Number: 2922
Principal diagnosis on summary is 'Adhesions secondary to hemicolectomy'. Patient had laparoscopic division of adhesions. Past history: Hemicolectomy approximately one year ago.
I am unsure which code to assign as principal diagnosis - K66.0 Peritoneal adhesions or K91.8 Other postprocedural disorders of digestive system, not elsewhere classified (with additional diagnosis K66.0).
Following ACS 1904 Procedural complications coders should look up Adhesion, postprocedural. There is an Index entry at this point but there is no default and none of the essential modifiers apply to this case. The ACS goes on to say 'If there is no subterm for postprocedural in the Index, follow the look up for Complication. But as there is a subterm (but no code), should I then assign the default at Adhesions K66.0?
The Index seems to be inconsistent as there is an entry for Adhesions, postprocedural, pelvic peritoneal, N99.4 but not Adhesions, postprocedural, abdominal or peritoneal.
Search Details:
ACS 1904 Procedural complications
Diseases Index
I am unsure which code to assign as principal diagnosis - K66.0 Peritoneal adhesions or K91.8 Other postprocedural disorders of digestive system, not elsewhere classified (with additional diagnosis K66.0).
Following ACS 1904 Procedural complications coders should look up Adhesion, postprocedural. There is an Index entry at this point but there is no default and none of the essential modifiers apply to this case. The ACS goes on to say 'If there is no subterm for postprocedural in the Index, follow the look up for Complication. But as there is a subterm (but no code), should I then assign the default at Adhesions K66.0?
The Index seems to be inconsistent as there is an entry for Adhesions, postprocedural, pelvic peritoneal, N99.4 but not Adhesions, postprocedural, abdominal or peritoneal.
Search Details:
ACS 1904 Procedural complications
Diseases Index
Response
VICC considers that because the adhesions have been described as 'secondary to', it represents a causal link. It is therefore correct to follow ACS 1904 Procedural complications and to follow the Index entry Complication/digestive/postprocedural/specified to assign K91.8 Other postprocedural disorders of digestive system, not elsewhere classified.
VICC acknowledges the lack of default code at subterm 'postprocedural' under the Index entry Adhesions/postprocedural and the absence of an essential modifier for abdominal and suggests you may wish to consider a public submission to ACCD asking for improvements to the Index in this area.
VICC acknowledges the lack of default code at subterm 'postprocedural' under the Index entry Adhesions/postprocedural and the absence of an essential modifier for abdominal and suggests you may wish to consider a public submission to ACCD asking for improvements to the Index in this area.
