by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA
Imagine having to have a paracentesis several times a week, just to drain off peritoneal ascites so you can feel comfortable. Until recently, there was no other way to remove the huge amount of fluid that can accumulate in the peritoneal cavity of patients with refractory ascites. It can be painful, time-consuming, and costly. A new device called an Alfapump eliminates this problem.
The device consists of an implantable pump and indwelling catheters. The pump is rechargeable using a patient-held wand for about 30 minutes per day and can be programmed to pump to meet the patient’s needs.
The FY2021 ICD-10-PCS Update includes two new codes to describe the Alfapump device placement. The coding for this device is similar to the coding of many other two-part devices, like a pacemaker or neurostimulator with one exception: in this device, there are no leads. This device uses catheters that are placed percutaneously to form a permanent bypass between the peritoneal cavity and the bladder.
The new PCS codes include the use of Y, Other Device in the Subcutaneous Tissue and Fascia body system for the body part of 8, Abdomen to describe the working unit of this two-part device. The other new code includes the addition of a qualifier to the Anatomical Regions, General body system of 6, Bladder to describe the destination of the bypass.
Alfapump coding looks like this:
0JH80YZ Insertion of other device into the subcutaneous tissue and fascia of the abdomen, open approach
0W1G3J6 Bypass of peritoneal cavity to bladder with synthetic substitute, percutaneous approach
There are more changes for FY 2021. For detailed information, see my ICD-10-PCS Code Updates course for Libman Education.
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