Coding, Classification & Reimbursement

Subject: 2018 PCS Guideline - Control vs. More Definitive Root Operations

1.  2018 PCS Guideline - Control vs. More Definitive Root Operations

Posted 05-19-2017 14:58
HI all

Asking for others interpretation of the 2018 update to PCS guideline B3.7  Control vs. more definitive root operations.

I am wondering about the addition of the phrase "such as".   Does this mean that any definitive root operation done to control  acute bleeding is coded to the more definitive root operation rather than to Control?  The old guideline was limited to seven specific root operations which superseded the use of the Control root operation.

What about an occlusive procedure?  Or, what about a suture repair?  Would these be coded to Occlusion and Repair rather than control?
I am unsure.  Looking forward to hearing others' thoughts.

The updated guideline is listed below with new information highlighted and deleted information listed with strike through.

Control vs. more definitive root operations

B3.7

The root operation Control is defined as, "Stopping, or attempting to stop, postprocedural or other acute bleeding." If an attempt to stop postprocedural or other acute bleeding is initially unsuccessful, and to stop the bleeding requires performing any of the a more definitive root operations operation, such as Bypass, Detachment, Excision, Extraction, Reposition, Replacement, or Resection, then that root operation is coded instead of Control.

Example: Resection of spleen to stop bleeding is coded to Resection instead of Control.

Guideline URL:  https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2018-PCS-Guidelines.pdf

Thanks,

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[Maggie] [Foley]
[Associate Professor]
[Temple University]
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2.  RE: 2018 PCS Guideline - Control vs. More Definitive Root Operations

Posted 05-20-2017 10:54
That is a good question. Wouldn't it depend if the Occlusion or Repair (suture) was the original root operation and it was initially unsuccessful and a more definitive root operation such as Bypass, Detachment, Excision, Extraction, Reposition, Replacement, or Resection, was then used? Then one of these more definitive root operations would be coded.  But if the initial attempt is Occlusion or Repair, wouldn't that go to Control since there was not any unsuccessful attempts (if that was the original intent) or are they also considering nonsurgical attempts like packing or cautery/silver nitrate that were unsuccessful in stopping the bleeding?

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Karen Neal
Coding Quality Auditor
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