AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 1; Ask the Editor
Esophagectomy with Colon Interposition
A woman diagnosed with an esophageal malignancy underwent total resection of the lower esophagus and reconstruction using colonic interposition. An esophagectomy was performed via an open approach. The terminal ileum was mobilized, together with the ascending and transverse colon, and was brought up and anastomosed to the cervical esophagus. The ascending and transverse colon that was still attached to the left colonic artery for blood supply was used as graft. How should the resection of the lower esophagus, along with colon interposition be coded? ...
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Article Overview
This premium coding article focuses on procedure coding for an open esophageal cancer surgery that includes lower esophageal resection and reconstruction using colon interposition. It is intended for coding professionals who need to understand the procedure context, the relevant ICD-10-PCS assignment, and the relationship between the resection and reconstruction components of the case. The article presents a concise scenario and a coding outcome for the operative approach and resection site.
Why This Topic Matters
Esophagectomy cases with colon interposition can be difficult to code because the operative report combines resection and reconstructive steps. This article helps coders identify the principal procedure being reported and understand how the case is represented in the procedure code set.
What You Will Learn
- How an esophageal resection with colon interposition is framed for procedure coding.
- How the operative approach and anatomic site factor into the coding scenario.
- How the case is represented in ICD-10-PCS terminology.
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Who Should Read This
- Inpatient coders
- Coding educators
- Clinical documentation improvement specialists
- Health information management professionals
Codes Discussed
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