Let's look at the root operations Restriction and Occlusion. Navigating these terms can often pose a significant challenge for coders, especially when determining the appropriate root operation for a procedure. Coders are responsible for analyzing the documentation within the medical record to accurately discern the objective of the procedures performed, which is the basis for the root operation selection. With physicians increasingly incorporating terms like restriction and occlusion into their statement of procedure, it's imperative that coders review the entire procedure note to determine the actual objective of the procedure
The objective of the root operation "Restriction," is partial closure of an orifice or the lumen of a tubular body part—a process often described as “partial occlusion”. In ICD-10-PCS, tubular body parts are defined as hollow structures facilitating the passage of solids, liquids, or gases. Through the use of intraluminal and/or extraluminal devices, restriction procedures aim to narrow the diameter of a tubular body part or a natural or artificially created orifice.
In contrast, the objective of the root operation "Occlusion," is completely closing an orifice or the lumen of a tubular body part. Through the use of intraluminal and/or extraluminal devices, a tubular body part or natural or artificial orifice is completely closed off, no longer allowing for the passage of solids, liquids or gases.
In essence, the key distinction between the root operations Restriction and Occlusion lies in their objective: restriction partially closes the orifice or lumen of a tubular body part, while occlusion completely closes it off.
Deepen your understanding of the application of these and other root operations with ICD-10-PCS Understanding Root Operations, instruction designed specifically to help you build proficiency in handling complex procedures.
References:
ICD-10-PCS Official Guidelines for Coding and Reporting
ICD-10-PCS Reference Manual
ICD-10-CM/PCS Coding Clinic, Third Quarter 2015 Page: 30
ICD-10-CM/PCS Coding Clinic, Third Quarter 2014 Pages: 26-28
ICD-10-CM/PCS Coding Clinic, First Quarter 2014 Pages: 9 & 24
ICD-10-CM/PCS Coding Clinic, Second Quarter 2015 Page: 27
ICD-10-CM/PCS Coding Clinic, Fourth Quarter 2014 Page: 37
ICD-10-CM/PCS Coding Clinic, Fourth Quarter 2021 Page: 63
ICD-10-CM/PCS Coding Clinic, Third Quarter 2021 Page: 23
In this coding course, participants will delve into the intricacies of ICD-10-PCS coding, focusing primarily on the Medical and Surgical Section. Through comprehensive readings from the ICD-10-PCS Reference Manual and Official Coding Guidelines, learners will gain a thorough understanding of root operations and their definitions, with a special emphasis on distinguishing between Control and more specific root operations. This course equips coders with the knowledge to make accurate code assignments when dealing with postprocedural or other acute bleeding scenarios. Practical examples and real-world cases, such as the management of bleeding duodenal ulcers and intraoperative hemorrhages, will be explored to reinforce these concepts.
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The information contained in this blog post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.