AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2015 Issue 4; Ask the Editor
Ravitch Operation
A patient with congenital pectus excavatum was admitted for repair. A Ravitch type procedure was performed. The cartilage was resected at the 4th through 6th intercostal arches bilaterally, the xyphoid was resected and a wedge shaped sternal osteotomy was made at the point of sternal angulation. The rectus muscle was reconstructed and fixed to the underside of the sternal table resulting in significant relief of the posterior angulation of the sternum. Typically a metal bar is utilized to stabilize the sternum, however, in this case the bar was not utilized. What is the correct code in ICD-10-PCS for this procedure? ...
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Article Overview
This article explains a surgical chest wall repair performed for congenital pectus excavatum and focuses on how the operative approach is translated into ICD-10-PCS. It is useful for facility coders, coding auditors, and clinical documentation staff who work with thoracic surgery and inpatient procedure coding. The discussion centers on the procedure type, relevant anatomic concepts, and the coding question raised by the operative details.
Why This Topic Matters
Chest wall repair procedures can be coded differently depending on the operative technique and documentation. Understanding the procedure context helps coders and reviewers identify the appropriate ICD-10-PCS category for inpatient reporting.
What You Will Learn
- How the Ravitch operation is described in surgical terms
- How the procedure relates to inpatient ICD-10-PCS coding
- Which documentation elements are relevant when reviewing a chest wall repair case
- How operative details can affect procedure classification
Who Should Read This
- Inpatient coders
- Coding auditors
- Clinical documentation integrity specialists
- Thoracic surgery billing staff
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