by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA
The Intracranial CSF Diversion procedure, also known as an endoscopic 3rd ventriculostomy, caused coding problems in the early years of ICD-10-PCS. This procedure creates a bypass between the 3rd cerebral ventricle and a cerebral cistern in the brain by creating a hole. The ICD-10-PCS code set was not cooperating in detailed coding of this procedure because the code set required a device to create this bypass. The correct coding of this bypass in 2015 through 2017 was a percutaneous endoscopic repair of the cerebral ventricle.
This issue was finally addressed in the FY 2018 changes which brought multiple additions to the ICD-10-PCS code set, many of which were necessary for both pediatric and adult coding. This addition gave us the ability to code the 3rd ventriculostomy bypass appropriately without a device. This intracranial CSF diversion procedure is performed for noncommunicating hydrocephalus and may eliminate the need for a ventriculoperitoneal or other shunt for the patient and also eliminate the possibility of complications frequently associated with the shunts. For more on this procedure, see the fact sheet on Endoscopic Third Ventriculostomy, found here.
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