腹主动脉瘤腔内修复术ICD编码分析

Analysis on the ICD Coding for Endovascular Repairment of Abdominal Aortic Aneurysms

腹主动脉瘤是血管外科常见的一种动脉退行性疾病,可以发生在主动脉任何节段,尤以肾下部位最常见,目前主要的手术方式有开放手术,即腹主动脉瘤切除及人工血管重建术,以及腹主动脉瘤腔内修复术,首选治疗措施是腹主动脉瘤腔内修复术,编码于39.71。EVAR手术中进行的髂动脉支架置入应根据其手术目的选择编码,手术目的是治疗腹主动脉瘤时,仍编码于39.71。髂动脉支架置入的手术目的是治疗髂动脉瘤时,应对其进行附加编码,编码于39.79,手术目的是治疗非髂动脉瘤的髂动脉病变时才能编码于39.90。对于使用了开窗支架术的EVAR手术,还应对开窗手术进行附加编码,编码于39.78。编码EVAR手术时,要认真阅读手术记录,严格按照手术编码的查找步骤,在类目表中核对编码,根据类目表中的另编码和不包括等提示选择正确的编码。

Abdominal aortic aneurysm is a common arterial degenerative disease in vascular surgery,which can occur in any segment of the aorta,especially in the sub-renal area.Currently,the main surgical methods include open surgery,namely excision of the abdominal aortic aneurysm and artificial vascular reconstruction,and endovascular repair of the abdominal aortic aneurysm.The preferred treatment is endovascular repair of the abdominal aortic aneurysm(code:39.71).Iliac artery stenting performed during EVAR surgery should be coded according to its surgical purpose,which is still coded at 39.71 when the surgical purpose is to treat abdominal aortic aneurysms.When the surgical purpose of iliac artery stenting is to treat iliac aneurysms,it should be coded at 39.79,and when the surgical purpose is to treat iliac artery lesions in non-iliac aneurysms,it can be coded at 39.90.For EVAR procedures that use fenestration stenting,additional codes for fenestration procedures should also be given at 39.78.When coding EVAR surgery,it is necessary to carefully read the surgical records,strictly follow the procedure of searching the surgical code,check the code in the category table,and select the correct code according to the other code and not included in the category table.