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Why is Pediatric ICD-10-PCS Coding Different from Adult?

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

If you are a coder in a pediatric setting, you know that pediatrics is just different from adult medicine. This is especially true in surgical procedures. Adult surgery frequently deals with fixing degeneration or trauma; things that happen to a person. Pediatric surgery often deals with complex reconstructions of congenital anomalies; things that the child was born with or develop incorrectly.

For example, in pediatrics, the three-stage palliation of Hypoplastic Left Heart Syndrome is quite complex. Even after all three procedures necessary to address the condition, the heart will never look like the average adult heart that needs a coronary artery bypass graft. Someone once said to me that coding “is much easier when the body is put together the way it’s supposed to be.” While adults are often put together “correctly,” with a standard starting point, pediatric coders know there is no counting on that when dealing with the broad range of anomalies and congenital conditions addressed by their hospital.

As a coder, charged with accurately and completely coding a pediatric surgical procedure, one should start with the anomaly itself. Understanding how the structures have developed incorrectly can help with understanding what reconstruction methods are being used. In pediatrics, one also needs to understand what accommodations are made for future growth and development. Staged surgery is common.

How does one learn about the unique reconstruction methods used in pediatrics? The internet, in particular websites of companies that sell devices or tools for pediatric surgery, can provide a wealth of information on the procedures themselves and videos that illustrate the corrective processes. To pull it all together, you may want a course such as my ICD-10-PCS for Pediatrics Coding, a suite of courses organized by body system, written for Libman Education.

Once a coder fully understands the reconstruction methods and the documentation as provided, then coding is a matter of following the conventions, the definitions, and the guidelines of the PCS system. In this way, ICD-10-PCS coding of pediatric procedures is not so different.



ICD-10-PCS for Pediatrics Coding Suite
Comprehensive and complete guidance to ICD-10-PCS coding of procedures performed on pediatric patients. Lynn Kuehn, a nationally recognized expert in ICD-10-PCS coding, worked in conjunction with leading Children’s Hospitals to develop this program to address complex and unique pediatric procedures current performed by leading pediatric hospitals. Learn more here.

About the Author

Lynn Kuehn is president of Kuehn Consulting, LLC, a consulting firm specializing in coding for all settings and physician practice management issues. Lynn is a nationally recognized trainer on ICD-10-PCS and other HIM-related topics. Lynn served on the AHIMA Board of Directors and authored several of AHIMA’s most popular books including Procedural Coding and Reimbursement for Physician Services, CCS-P Exam Preparation, and ICD-10-PCS: An Applied Approach.

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