AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2014 Issue 3; Ask the Editor
Radical Resection of Level I Lymph Nodes
A patient with adenoid cystic carcinoma underwent resection of the parotid tail with sacrifice of the marginal mandibular branch of the facial nerve, resection of the parapharyngeal space, and bilateral radical resection of level I lymph nodes. The ICD-10-PCS Reference Manual, page 39, states “when an entire lymph node chain is cut out, the appropriate root operation is resection. When a lymph node(s) is cut out, the root operation is excision.” What is the correct ICD-10-PCS code assignment for radical resection of the level I lymph nodes? ...
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Article Overview
This premium article examines an ICD-10-PCS question involving a head and neck oncology case and the coding of lymph node removal in the level I region. It is aimed at coding professionals who need to understand how the ICD-10-PCS Reference Manual addresses lymph node chain procedures and how the article frames the distinction between broader and partial removal concepts.
Why This Topic Matters
Accurate ICD-10-PCS assignment for lymph node procedures affects inpatient procedure reporting, data integrity, and downstream quality and reimbursement workflows. The topic is especially relevant for coders working with oncologic head and neck surgery and complex operative reports.
What You Will Learn
- How the article frames lymph node procedure coding in ICD-10-PCS
- How the discussion distinguishes between broader and partial removal concepts
- How a head and neck surgical case is used to illustrate the coding topic
- How the ICD-10-PCS Reference Manual is cited in relation to lymph node chain procedures
Who Should Read This
- Inpatient coders
- ICD-10-PCS coding specialists
- Coding educators
- HIM professionals
- Auditors reviewing operative reports
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