AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 3; Ask the Editor
Placement and Removal of Cannulas for Extracorporeal Membrane Oxygenation
The patient was admitted with a large mediastinal goiter and underwent surgical removal of the goiter via median sternotomy, along with cannulation of bilateral femoral veins in anticipation of extracorporeal membrane oxygenation (ECMO) perfusion. Due to severe narrowing of the patient’s airway, there was concern that on induction of anesthesia, the airway would not be accessible and ECMO would be required as backup. Cannulas were placed in the right and left femoral veins and the cannulas were connected to the circuit. Anesthesia was induced and the patient was intubated without incident. Therefore, the use of ECMO was not needed. At the completion of the procedure, both cannulas were removed. Is it appropriate to assign an additional code for the cannulation when ECMO perfusion was not provided during the surgery? ...
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Article Overview
This premium coding article addresses a surgical scenario involving preparation for extracorporeal membrane oxygenation support, including placement and later removal of cannulas in the femoral veins. It is intended for coders, auditors, and clinical documentation staff who work with inpatient procedural coding and need to understand how ECMO-related access procedures are discussed in a case-based context. The article focuses on ICD-10-PCS code assignment and the relationship between the access procedures and the overall operative event.
Why This Topic Matters
ECMO-related procedures can be coded differently depending on what was performed and documented. This article helps readers understand how a specific operative situation is framed for coding review, which is important for accurate inpatient procedure reporting and compliance.
What You Will Learn
- How the article frames ECMO-related cannula placement in a surgical setting
- How the removal of cannulas is discussed in relation to the operative course
- What coding questions arise when ECMO support is prepared but not ultimately used
- How ICD-10-PCS is applied to this type of inpatient procedure scenario
Who Should Read This
- Inpatient coders
- Coding auditors
- Clinical documentation integrity specialists
- Hospital revenue cycle staff
- Health information management professionals
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