1. 0SG10AJ Root Operation: Fusion, Lumbar Vertebral, 2 or more (0SG1)

Rationale: Two joints were fused, so the body part for the fusion is 1, Lumbar Vertebral Joints, 2 or more. The insertion of the pedicle screws is not coded separately. A code is not assigned for the nonautologous bone graft per ICD-10-PCS Coding Guideline B3.10c, which states that if an interbody fusion device is used to render the joint immobile (containing bone graft or bone graft substitute), the procedure is coded with the device value Interbody Fusion Device.

2. 090K0JZ Root Operation: Alteration, Nasal Mucosa and Soft Tissue (090K)

Rationale: Rhinoplasty, see Alteration, Nasal Mucosa and Soft Tissue; see Repair, Nasal Mucosa and Soft Tissue; see Replacement, Nasal Mucosa and Soft Tissue; see Supplement, Nasal Mucosa and Soft Tissue. Alteration is the correct root operation because the procedure is cosmetic in nature.

3. 0RGS34Z Root Operation: Fusion; Carpometacarpal Joint, Right (0RGS)

Rationale: There are only two choices of body systems for Fusion procedures: Lower Joints (0SG) and Upper Joints (ORG). The thumb is located above the diaphragm, and therefore is considered to be an upper joint.

4. 0W4M070 Root Operation: Creation, Perineum, Male (0W4M0)

Rationale: The body part value pertains to the current sex of the patient and the qualifier identifies the body part being created. 0W4M070’s code description is “Creation of Vagina in Male Perineum with Autologous Tissue Substitute, Open Approach.”

5. 0SG107J Root Operation: Fusion, Lumbar Vertebral, 2 or more (0SG1)

0PB10ZZ Root Operation: Excision Ribs, 1 to 2 (0PB1)

Rationale: Two joints were fused, so the body part for the fusion is 1, Lumbar Vertebral Joints, 2 or more. The correct device character is “7” Autologous Tissue Substitute because the fusion was accomplished with bone graft taken from the patient’s own rib. A second code is assigned for the harvesting of bone graft material from the patient’s right rib. Coding Guideline B3.9 states that if an autograft is obtained from a different procedure site in order to complete the objective of the procedure, a separate procedure is coded. The insertion of the pedicle screws is not coded separately.

6. 0H0V0JZ Root Operation: Alteration, Breast, Bilateral (0H0V)

Rationale: There is no Alphabetic Index term for Augmentation. It is necessary to understand that the root operation for this procedure is Alteration because it is done for cosmetic purposes.

7. 0W0F0ZZ Root Operation: Alteration, Abdominal Wall (0W0F)

Rationale: Abdominoplasty – see Alteration, Abdominal Wall (0W0F); see Repair, Abdominal Wall (0WQF); see Supplement, Abdominal Wall (0WUF). Alteration is selected because the principal purpose is to improve appearance.