The root operation Extraction was added to the Hepatobiliary System and Pancreas, creating a new table 0FD, Hepatobiliary System and Pancreas, Extraction. This will allow capturing additional detail for percutaneous aspiration biopsies and brush biopsies.
|0FD||Hepatobiliary System and Pancreas|
In code table 0F5, Hepatobiliary System and Pancreas, Destruction, a new qualifier for irreversible electroporation was created for the body part values noted below:
1 Liver, Right Lobe
2 Liver, Left Lobe
|F Irreversible Electroporation|
Irreversible electroporation (IRE) is a new non-thermal tissue ablative modality used to treat advanced hepatic and pancreatic cancer patients. IRE works by delivering micro to millisecond electrical pulses to cancer tissue to produce cell death through irreversible cell membrane permeabilization. IRE affects only the cell membrane and no other structure in the tissue. IRE is an alternative modality to thermal ablation procedures such as cryoablation and radiofrequency ablation procedures, which have been associated with destruction of adjacent tissue. IRE may be utilized via open procedure, laparoscopically or percutaneously.
A female patient with locally advanced, unresectable stage III cancer of the body of the pancreas underwent laparoscopic irreversible electroporation to ablate the pancreatic tumor. How should this be coded?
Assign C25.1, Malignant neoplasm of body of pancreas, for the diagnosis of stage III cancer of the body of the pancreas.
Assign the following ICD-10-PCS code for the irreversible electroporation ablation of the pancreas:
0F5G4ZF Destruction of pancreas using irreversible electroporation, percutaneous endoscopic approach