1.  0X690Z2 Root Operation: Detachment

Detachment, Arm, Upper, Left (0X690Z)

Amputation, see Detachment

Rationale: Amputation, see Detachment. When an amputation is performed, the body part is detached from the body as a whole. To find the appropriate procedure code, see Detachment, Arm, Upper, Left in the Index.

2.  0U5C7ZZ Root Operation: Destruction, Cervix (0U5C) 0U5G7ZZ Root Operation: Destruction, Vagina (0U5G) 0U5MXZZ Root Operation: Destruction, Vulva (0U5M)

Rationale: Three codes are required for this procedure since condylomas were removed from three separate and distinct body parts, cervix, vagina and vulva. The root operation Destruction is the correct root operation for all three procedures, as a laser was utilized to obliterate the condylomas. The approach for the cervix and vagina is 7, Via Natural or Artificial Opening, and the approach for the vulva is X, External.

3.  0GTG4ZZ Root Operation: Resection, Thyroid Gland, Left Lobe (0GTG) 07B24ZX Root Operation: 

Excision, Lymphatic, Neck, Left (07B2)

Rationale: The lobes of the thyroid have their own distinct body part values in ICD-10-PCS. 

Therefore, this is a Resection of the left thyroid lobe rather than an Excision of the thyroid gland.

4.  08DJ3ZZ Root Operation: Extraction, Lens, Right (08DJ3)

Rationale: The right eye cataract is removed via phacoemulsification, extracting the lens of the right eye.

5.  0BBF8ZX Root Operation: Excision, Lung, Lower Lobe, Right (0BBF)

Rationale: The biopsies are taken in the right lower lobe of the lung, accessed via a bronchoscopy with an approach through the transbronchial branch. Excision is removing a portion of the body part. The biopsies only remove a portion of the lung.

6.  0B578ZZ Root Operation: Destruction, Bronchus, Main, Left (0B57)

Rationale: During this procedure, the Nd:YAG laser is used to obliterate the lesion in the left main bronchus so that the lesion is no longer present.

7.  0BTF0ZZ Root Operation: Resection, Lung, Lower Lobe, Right (0BTF)

Rationale: The root operation is Resection as this was a removal of a section of the lung with its own 8 unique body part value, via an open approach.

8.  0UBC7ZZ Root Operation: Excision, Cervix (0UBC)

Rationale: A LEEP conization removes abnormal cervical tissue to prevent cervical cancer.

9.  0FT40ZZ Root Operation: Resection, Gallbladder (0FT4) 0FJ44ZZ Root Operation: Inspection, Gallbladder (0FJ4)

Rationale: In this case, a laparoscopic procedure was attempted, but converted to an open procedure. See Coding Guideline B3.2d. Multiple procedures are coded if the intended root operation is attempted using one approach but is converted to a different approach.

10. 0Y6D0Z3 Root Operation: Detachment, Leg, Upper Left (0Y6D0Z) Amputation see Detachment Rationale: The left upper leg (body part value D) is detached at the distal end of the femur, qualifier value 3 or Low amputation.

11. 0DBM8ZX Root Operation: Excision, Colon, Descending (0DBM) Biopsy see Excision 0DBN8ZX Root Operation, Excision, Colon, Sigmoid (0DBN)

Rationale: Two biopsies were performed during this procedure, one in the descending colon and one in the sigmoid colon. ICD-10-PCS Coding Guideline B3.2a states that if the same root operation is performed on different body parts that have their own distinct body part value, a code should be assigned for each of the different body parts, but Coding Clinic Q4 2014 clarifies Guideline B3.2b as referring to distinct body parts, not different locations within the same body part.

12.  0DTN4ZZ Root Operation: Resection, Sigmoid Colon (0DTN) Rationale: The entire sigmoid colon was resected via laparoscopic endoscopy.

13. 0JD83ZZ Root Operation: Extraction, Subcutaneous Tissue and Fascia, Abdomen (0JD8)

Rationale: Liposuction uses suction, which is a form of force, to remove fat from the body. This meets the definition of the root operation Extraction, “Pulling or stripping out or off all or a portion of a body part by the use of force”.

14. 06DY3ZZ Root Operation: Extraction, Vein, Lower (06DY)

Rationale: Stripping of a varicose vein involves pulling the vein from the leg. This meets the definition of the root operation Extraction, “Pulling or stripping out or off all or a portion of a body part by the use of force”.

15. 0X690Z3 Root Operation: Detachment, Arm, Upper, Left (0X69)

Rationale: Amputation is reported with the root operation Detachment. Amputation above the elbow is classified as a low amputation.