Question

Question 8 (9 points) Please assign the correct ICD-10-PCS codes to the following operative report: PREOPERATIVE DIAGNOSIS: Left ureteral calculus POSTOPERATIVE DIAGNOSIS: Same OPERATION: Cystoscopy, bilateral retrograde pyelograms, left ureteroscopy with electrohydraulic lithotripsy, and basket extraction of calculi PROCEDURE: The patient is brought to the cystoscopy suite, where general anesthesia is induced and maintained in the usual fashion without difficulty. The patient then is placed in the dorsal lithotomy position, and the external genitalia are prepped and draped in a routine fashion. A 21-French ACMI panendoscope is assembled and inserted into the patient's bladder without difficulty. Inspection revealed the prostate to be mildly enlarged, but not particularly obstructed. The bladder itself is unremarkable. The ureteral orifices are normal. There is no efflux at all from the left side, a clear efflux from the right. Bilateral retrograde pyelograms are taken using low osmolar contrast media. On the left side, an obvious large stone is obstructing the middle third of the ureter. On the right side, the retrograde pyelogram is normal. A guide wire is passed into the left ureteral orifice under fluoroscopy and can go past the stone into the renal pelvis. The guide wire is left in place. A cystoscope is now removed, and a ureteroscope is passed alongside the guide wire up to the midureter. There is some mild difficulty in passage but this is accomplished. A large stone was fragmented with lithotripsy. A total of only about 30 shocks are needed to fragment the stone quite easily. At this point, the surgeon was able to basket the large remaining fragments, and stone extraction was completed. Very tiny fragments remain in the ureter but will pass safely. After ureteroscopy with basket extraction is completed, a cystoscope is reinserted over the guide wire into the bladder. A 7-French, 26 cm double J stent is then passed under fluoroscopy into the renal pelvis, where a good coil forms. The guide wire is then carefully removed. Good positioning of the stent is verified. The procedure is completed. Blank 1:

Answer 1

ICD-10-PCS code 0TJB8ZZ for Inspection of Bladder via natural opening endoscopic.

ICD-10- PCS code 0T778DZ for for Dilation,ureter via natural opening endoscopy,intraluminal device

ICD-10-PCS code BT131ZZ for Bilateral retrograde pyelograms,low osmor media

ICD-10-PCS code 0TF7XZZ for left ureter lithotripsy