A patient diagnosed with walled off pancreatic necrosis and pancreatic pseudocyst adjacent to the stomach body, underwent endoscopic cystogastrostomy using the AXIOS™ Stent system. The endoscope was placed under direct vision, and the stomach wall and pancreatic pseudocyst were punctured under endosonographic guidance. An AXIOS™ stent was placed in close approximation to the walls of the cyst and the stomach through the cystogastrostomy. Dark brown fluid was drained from the stent. A gastroscope was advanced into the stomach under direct visualization, a wire was inserted through the AXIOS™ stent into the cyst cavity under fluoroscopic guidance, and a dilating balloon was then advanced over the wire with successful dilation of the tract. A large necrotic cavity was visualized, and a catheter was placed into the AXIOS™ stent under endoscopic and fluoroscopic guidance to maintain patency. What is the appropriate code assignment for cystogastrostomy using the AXIOS™ stent? Is it appropriate to report additional codes for balloon dilation of the tract and dilation of the AXIOS™ stent? If so, what are the correct code assignments?
Assign the following ICD-10-PCS code:
0F9G80Z Drainage of pancreas with drainage device, via natural or artificial opening endoscopic, for the cystogastrostomy with AXIOS™ stent, to drain the cyst.
The provider documented that the stomach wall and the cyst were punctured under endosonographic guidance. An AXIOS™ stent was placed in close approximation to the walls of the cyst and stomach through the cystogastrostomy, and fluid was drained from the cyst. Separate codes are not assigned for balloon dilation of the cystic tract or for the dilation of the AXIOS™ stent, to maintain patency, as they were not performed with distinct objectives.