![]() The approach value for placement of a port-a-cath should be “Open” (rather than percutaneous). Although we agree with the device value, the approach value is inaccurate. In Coding Clinic, Fourth Quarter 2013, pages 116- 117, information was published about the device character for the insertion of a totally implantable central venous accessĭevice (port-a-cath). Totally Implantable Central Venous Access Device (Port-a-Cath)- Q2 2015 In ICD-10-PCS, a percutaneous approach is defined as entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach the site of the procedure. The device has a small reservoir, but it does not function as a reservoir to store medicine during the course of therapy.Īssign the ICD-10-PCS code as follows: 0JH63XZ Insertion of vascular access device into chest subcutaneous tissue and fascia, percutaneous approach. When assigning an ICD-10-PCS code for insertion of a port-a-cath, what device character should we select? Would a port-a-cath be considered a reservoir (character “W”) or a vascular access device (character “X”)?Ĭode only the vascular access device (VAD). The catheter was advanced into the vein, tunneled under the skin and attached to the port, which was anchored in the subcutaneous pocket. An incision was made in the anterior chest wall and a subcutaneous pocket was created. Device Character for Port-A-Cath Placement- Q4 2013 When the provider’s documentation does not specify the end placement of the infusion device, the imaging report may be used to identify the body part. For coding purposes, can imaging reports be used to determine the end placement of the device? When coding the placement of an infusion device such as a peripherally inserted central catheter (PICC line), the code assignment for the body part is based on the site in which the device ended up (end placement). Use of Imaging Report to Confirm Catheter Placement- Q3 2014 AHA Coding Clinic 3rd Quarter 2014 page 5-6, advices that imaging reports can be used to identify end placement of the catheter for appropriate body part coding when provider documentation does not specify.ĪHA Coding Clinic Advice For ICD-10-CM/PCS Related To Venous Catheters & Linesīelow are several AHA Coding Clinic references related to catheters and other venous access devices for ICD-10-CM/PCS that may be beneficial while coding or researching this topic.Physician documentation is needed for the intended use of the line and the anatomical site that the catheter ends up.ICD-10-PCS Coding Tips for Venous and Arterial catheters: Arterial lines are generally not used for administration of medications or fluids. Most frequent care settings are intensive care unit or anesthesia when frequent blood draws or blood pressure monitoring are needed. Common uses for PICC lines are chemotherapy, extended antibiotic regimens, total parenteral nutrition (TPN), and blood samples for laboratory tests.Īrterial Line– (also known as: a-line or art-line) a thin catheter inserted into an artery most commonly radial, ulnar, brachial, or dorsalis pedis artery. ![]() ![]() When inserted the tip of the catheter resides in the superior vena cava or cavoatrial junction. Peripheral Lines– (PICC) a peripheral catheter inserted into a vein for prolonged intravenous access to administer medications over a long period of time. Common uses are for medication and fluid administration. This article aims to provide greater clarity with regard to procedure coding tips for coding of venous catheters.Ĭentral Lines– (CVC)- Central Venous Catheter or central lines are inserted into large veins, typically the jugular, subclavian, or femoral vein. One challenging coding area with the ICD-10 transition is the coding of venous and arterial lines and catheters.
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