AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 1; Ask the Editor
Repositioning of Impella Short-Term External Heart Assist Device
A patient had an Impella short-term external heart assist device implanted during surgery, which remained after completion of the procedure. The following day, the surgeon noted diminished flows and dislodgement of the device from its original position. The patient was returned to the operating suite and underwent coronary artery bypass grafting and repositioning of the Impella. The surgeon performed the repositioning under transesophageal echocardiographic guidance using a repositioning unit. What is the correct root operation and approach value for repositioning of the Impella? If the procedure were performed at the patient’s bedside, would that affect code assignment? ...
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Article Overview
This article explains a postoperative coding scenario centered on an Impella short-term external heart assist device that required repositioning after it was found displaced. It is intended for inpatient coders, coding educators, and clinicians involved in procedure documentation review who need to understand the relevant ICD-10-PCS concepts and how the location of the procedure may affect code selection. The discussion focuses on the procedure classification framework, the setting of service, and the coding implications of repositioning a malfunctioning or displaced device.
Why This Topic Matters
Device repositioning cases can be coded differently from the original implantation procedure, so accurate classification affects inpatient procedure reporting and data integrity. The article helps readers recognize how a displacement event and the care setting factor into ICD-10-PCS procedure coding.
What You Will Learn
- How a displaced implanted device is discussed within ICD-10-PCS procedure classification.
- What procedural setting details are relevant to the coding scenario.
- How the article frames the question of whether bedside performance changes the coding outcome.
- The general ICD-10-PCS concepts involved in device repositioning cases.
Who Should Read This
- Inpatient coders
- Coding auditors
- Coding educators
- Clinical documentation specialists
- Physicians and surgeons involved in procedure documentation
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