AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 3; Ask the Editor

Creation of Indiana Pouch

A patient underwent a simple cystectomy with creation of an Indiana pouch. During the procedure, dissection of the bladder was carried out. The ascending colon and ileum were divided and sutured creating a pouch, and the bowel was reanastomosed. The right ureter was tunneled through the bowel creating an ureterocolonic anastomosis, and a urinary diversion stent was passed into the patient’s right kidney. Through a separate incision, the left ureter was placed into the pouch and an additional urinary diversion stent was passed into the patient’s left renal pelvis. Prior to complete closure of the pouch a suprapubic catheter was placed and the bilateral ureteral stents were withdrawn from the lumen of the pouch. The remainder of the pouch was closed and a catheterizable stoma was created at the abdominal wall. What are the appropriate ICD-10-PCS code assignments for creation of an Indiana pouch and stoma following a cystectomy? ...

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