AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 4; ICD-10-PCS NEW/REVISED CODES
Intraoperative ECMO
In code table 5A1, Physiological Systems, Performance, new duration value A Intraoperative was added to enable differentiating Extracorporeal Membrane Oxygenation (ECMO) that is utilized for intraoperative support from ECMO that is utilized as life support. Intraoperative ECMO may be used as temporary circulatory support for the duration of a procedure such as a lung transplant or a high-risk percutaneous coronary intervention (PCI). Body SystemDurationFunctionQualifier5 Circulatory 2 Continuous A Intraoperative 2 Oxygenation F Membrane, Central G Membrane, Peripheral Veno-Arterial H Membrane, Peripheral Veno-venous ...
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Article Overview
This article reviews the coding of intraoperative extracorporeal membrane oxygenation (ECMO) in the context of ICD-10-PCS, with emphasis on how intraoperative support is distinguished from ongoing life support. It is aimed at medical coders, auditors, and reimbursement professionals who work with cardiology, cardiac catheterization, and transplant-related procedures. The article covers the relevant code table structure, duration/function qualifiers, and a clinical scenario involving temporary hemodynamic support during a procedure.
Why This Topic Matters
Correctly recognizing intraoperative ECMO affects procedure coding consistency for complex cases performed outside the operating room, including cardiac catheterization lab services and other high-acuity interventions.
Article Sections
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ICD-10-PCS table update
Introduces the relevant ICD-10-PCS table and notes the addition of a new duration value used to distinguish a type of ECMO support from other uses.
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Clinical context for intraoperative support
Describes general procedural settings where temporary extracorporeal support may be used, including major cardiac and thoracic interventions.
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Code table components
Presents the body system, duration, function, and qualifier elements associated with the ECMO-related table structure.
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Clinical scenario and coding question
Provides a patient case involving temporary circulatory support during an intervention and frames the coding issue related to where the procedure is performed.
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Coding clarification
Addresses whether the ECMO reporting concept applies in a catheterization lab setting and summarizes the general coding interpretation.
What You Will Learn
- How intraoperative ECMO is distinguished within ICD-10-PCS
- What procedural contexts are associated with temporary ECMO support
- How table elements relate to ECMO reporting
- Why the procedure setting may matter for coding review
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation improvement specialists
- Revenue cycle professionals
- Cardiology coding staff
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