A patient diagnosed with endometrial carcinoma underwent attempted robotic-assisted laparoscopic hysterectomy, converted to an open total abdominal hysterectomy and bilateral salpingo-oophorectemy. The robotic device was attached to the cervix and an attempt was made to mobilize the uterus. However, it was not possible to safely visualize the left uterine vessels; therefore, the robotic device was undocked and surgery was converted to an open procedure. What is the appropriate code assignment for attempted robotic-assisted laparoscopic hysterectomy, converted to an open total abdominal hysterectomy?
When the surgeon could not safely visualize the uterine vessels, the surgery was converted to open. The total abdominal hysterectomy and bilateral salpingo-oophorectemy are coded using the open approach, and laparoscopic inspection of the uterus is also coded. According to the ICD-10-PCS guideline B3.2d, when the intended root operation is attempted using one approach, but is converted to a different approach, the procedure(s) in the operative episode are coded to the approach ultimately used, and an Inspection procedure is coded using the approach value of the attempted approach. Assign the following ICD-10-PCS codes:
0UT90ZZ Resection of uterus, open approach (for the hysterectomy)
0UT70ZZ Resection of bilateral fallopian tubes, open approach (for the bilateral salpingectomy)
0UT20ZZ Resection of bilateral ovaries, open approach (for the bilateral oophorectomy)
0UTC0ZZ Resection of cervix, open approach (for removal of the cervix)
0UJD4ZZ Inspection of uterus and cervix, percutaneous endoscopic approach (for the attempted laparoscopic hysterectomy)
8E0W4CZ Robotic assisted procedure of trunk region, percutaneous endoscopic approach (for the attempted robotic-assisted surgery)