AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 2; Ask the Editor

Clipping (Occlusion) of Cerebral Artery, Decompressive Craniectomy and Storage of Bone Flap in Abdominal Wall

The patient was found comatose after a choking incident. She was admitted and work-up revealed a large left frontotemporal hematoma and left middle cerebral artery aneurysm. At surgery, the left frontotemporoparietal brain was severely swollen. The surgeon accomplished frontotemporoparietal decompressive craniectomy, clipping of left middle cerebral artery aneurysm, evacuation of left frontotemporal hematoma, duraplasty, and placement of the bone flap in the abdominal wall. How is the storage of the bone flap in the subcutaneous abdominal wall captured in ICD-10-PCS? Also, how is clipping of the left cerebral artery coded? The index entry under “Clipping” directs “see Restriction.” ...

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