AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2026 Issue 1; Ask the Editor

North-South Syndrome (NSS)

A patient with acute and persistent hypoxic and hypercapnic respiratory failure required emergent extracorporeal membrane oxygenation (ECMO). The ECMO initially started with veno-venous (VV)-ECMO with subsequent conversion to veno-arterial (VA)-ECMO because of continued increased pressor requirements; however, this was later reconfigured to veno-arterio-venous (VAV)-ECMO given that the patient developed North-South syndrome (NSS). NSS is a complication of VA-ECMO where oxygenated blood reinfused from the ECMO circuit supports lower body circulation while upper body circulation fails to receive adequate oxygenated blood from the lungs. What is the correct ICD-10-CM code assignment for NSS? ...

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