AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 2; Ask the Editor
Ex Utero Intrapartum Treatment Procedure
A pregnant patient presents at 38 weeks because the fetus was found to have a left upper lobe lung mass. The mother underwent the ex utero intrapartum (EXIT) procedure, in which the mass on the fetus’ lung was excised via low transverse hysterotomy. The head, neck, upper extremities and upper torso of the fetus were delivered through low transverse hysterotomy. The surgeon performed the thoracotomy and excision of the fetal lung mass while the fetus was still attached to the umbilical cord and placenta. The fetal thoracotomy was closed, and the lower torso and lower extremities of the fetus were delivered through the hysterotomy. The umbilical cord was then cut, and the infant was handed off to the surgical team for further stabilization/resuscitation. What is the appropriate procedure code assignment for the EXIT procedure to remove the mass from the fetal lung? ...
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Article Overview
This article explains how a premium coding resource approaches an ex utero intrapartum treatment (EXIT) procedure in the context of obstetric and fetal surgical care. It is aimed at coders and clinical documentation teams who need to understand the scope of the case, the procedure setting, and the coding framework used for the mother’s record. The guidance centers on procedure coding considerations tied to fetal intervention during delivery and the associated ICD-10-PCS assignment.
Why This Topic Matters
EXIT procedures are uncommon and documentation can be complex because the surgical intervention occurs while the fetus remains attached during delivery. Correct procedural classification depends on understanding the operative context and the code set involved.
What You Will Learn
- How an EXIT procedure is framed for coding purposes
- The clinical and procedural context of fetal intervention during delivery
- Which coding system is used for the mother’s record in this scenario
- How documentation supports procedure code assignment for rare obstetric cases
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation specialists
- Obstetric coding staff
- Hospital reimbursement staff
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