AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 1; Ask the Editor
Pubic Symphysis Fusion
The patient is a 34-year-old female diagnosed with symptomatic degenerative pubic symphysis, who failed conservative treatment, and is now undergoing pubic symphysis fusion. At surgery, the rectus abdominis was dissected to expose both the right and left pubis symphysis. Osteophytes were removed. Two screws were placed into the pubis and a pelvic reduction clamp was used to distract the pubis. It was taken down with sharp and blunt technique, removing the capsule along its depth. Once the capsule was released traction was placed on it to widen it up. An oscillating saw was used to decorticate each side of the pubis. The debris from the drilling and shavings were incorporated into the fusion. A Synthes pubic 6-hole plate was contoured to the pubis; two screws were placed on each side of the pubis and anchored into the bone. Screws were also placed in the pubic rami and anchored. In ICD-10-PCS, under the root operation “Fusion,” there is no body part value for pubic symphysis or pelvic bone. What is the correct ICD-10-PCS code assignment for fusion of the pubic symphysis? ...
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Article Overview
This premium article examines pubic symphysis fusion from a medical coding perspective. It is intended for coders and reimbursement professionals who need to understand how the procedure is described in the operative note, what code set considerations arise, and why anatomy-specific terminology can complicate code selection.
Why This Topic Matters
Procedures involving the pubic symphysis may not map cleanly to standard body-part terminology in procedural code sets, so accurate interpretation of the operative report is important for compliant reporting.
What You Will Learn
- How pubic symphysis fusion is described in an operative setting
- Why anatomy terminology can affect procedural coding analysis
- What coding considerations arise when reviewing this type of orthopedic fusion case
- How the article frames the issue within ICD-10-PCS
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle professionals
- Orthopedic billing staff
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