Question

Preoperative diagnosis: Multiple lung nodules

Postoperative diagnosis: Small cell carcinoma of the upper lobe of right lung

Procedure description: Thoracoscopic segmental resection of lung nodules

Indications: A 53 year old female presents to the hospital for resection of multiple lung nodules of the upper lobe of the right lung identified by previous outpatient radiological examination. The patient has smoked for 35 years and is a current two pack per day smoker. She also has a family history of lung cancer. Our objective today is to remove these nodules. Procedure performed: Two small incisions were made in the chest wall and carried down into the chest cavity by blunt dissection. A trocar was inserted through a small intercostal incision in the right side of the chest wall. An endoscope was passed through the trocar and into the chest cavity. The right lung was partially collapsed by instilling air into the chest through a second trocar placed via a separate incision. The contents of the chest cavity were examined under direct visualization. Via an endoscope, images were obtained of the lesions, and the instruments were manipulated through the secondary sites, clamping blood vessels and bronchial tubes at the segments of the lung containing the nodules. With the clamps in place, the nodules were removed by dividing the vessel and bronchial tubes isolated by the clamps. At the conclusion of the procedure, the endoscope and the trocars were removed. The collapsed lung was re-expanded. Surgical pathology examination is consistent with small cell carcinoma.

What is the ICD-10-PCS code assigned?

Answer 1

ICD-10-PCS code - OBTC4ZZ-  Resection of Right Upper Lung Lobe, Percutaneous Endoscopic Approach

O- Medical and surgical (Section)

B - Respiratory System (Body system)

T - Resection (Operation)

C - Upper lung lobe, right (Body part)

4 - Endoscopic approach

OBTC4ZZ-  Resection of Right Upper Lung Lobe, Percutaneous Endoscopic Approach