AHA Coding Clinic® for ICD-9 - 2010 Issue 4; Volume 3 New/Revised Codes
Insertion of Sternal Fixation Device with Rigid Plates
As of October 1, 2010, a new code has been created to describe the insertion of a sternal fixation device with rigid plates (84.94) for the prevention of sternal dehiscence (SD) and deep sternal wound infection following cardiothoracic surgery. Traditionally, sternal closure following cardiothoracic surgery was done using sternal wiring. However, sternal dehiscence with or without infection is a major source of morbidity and mortality. The incidence of sternalcomplications is increased by obesity, osteoporosis, and chronicobstructive pulmonary disease as well as by factors relatedto wound healing (e.g., diabetes or corticosteroid use). Studies have demonstrated that rigid plate...
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Article Overview
This article covers a new inpatient procedure code introduced for rigid plate fixation of the sternum, along with background on why this technique is used after cardiothoracic surgery. It also includes a coding discussion for a postoperative wound dehiscence scenario involving sternal debridement and fixation, making it relevant to hospital coders, CDI staff, and cardiovascular surgery coding specialists.
Why This Topic Matters
Accurate understanding of this update helps coders distinguish the new rigid-plate sternal fixation procedure from other internal fixation procedures and recognize how it is discussed in the setting of postoperative sternal wound complications.
Article Sections
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Overview of rigid plate sternal fixation
Introduces the procedure update, its effective date, and the clinical context in which rigid plate fixation is used following cardiothoracic surgery.
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Background and clinical rationale
Summarizes traditional sternal closure practices and describes the broader complication context that led to interest in rigid fixation approaches.
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Primary procedure steps
Outlines the general operative steps involved in fixation of the sternum with rigid plates.
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New code and exclusions
Presents the newly created procedure code and notes adjacent categories that are not included in this topic.
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Coding example
Provides a postoperative hospital coding scenario involving sternal wound disruption and operative management after prior cardiac surgery.
What You Will Learn
- The clinical context for rigid plate fixation of the sternum
- How the article frames the new procedure category
- The general operative workflow for sternal plate fixation
- The type of postoperative coding scenario discussed in the article
Who Should Read This
- Inpatient coders
- Clinical documentation improvement staff
- Cardiovascular surgery coding specialists
- Revenue integrity professionals
Codes Discussed
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