CLASSIFICATION OF PROCEDURES
0. PROCEDURES AND INTERVENTIONS , NOT ELSEWHERE CLASSIFIED (00)
00 Procedures and interventions, Not Elsewhere Classified
00.0 Therapeutic ultrasound
Excludes: diagnostic ultrasound (non-invasive) (88.71-88.79)
intracardiac echocardiography [ICE] (heart chamber(s)) (37.28)
intravascular imaging (adjunctive) (00.21-00.29)
00.01 Therapeutic ultrasound of vessels of head and neck
Anti-restenotic ultrasound
Intravascular non-ablative ultrasound
Excludes: diagnostic ultrasound of:
eye (95.13)
head and neck (88.71)
that of inner ear (20.79)
ultrasonic:
angioplasty of non-coronary vessel (39.50)
embolectomy (38.01, 38.02)
endarterectomy (38.11, 38.12)
thrombectomy (38.01, 38.02)
00.02 Therapeutic ultrasound of heart
Anti-restenotic ultrasound
Intravascular non-ablative ultrasound
Excludes:diagnostic ultrasound of heart (88.72)
ultrasonic ablation of heart lesion (37.34)
ultrasonic angioplasty of coronary vessels (00.66, 36.09)
00.03 Therapeutic ultrasound of peripheral vascular vessels
Anti-restenotic ultrasound
Intravascular non-ablative ultrasound
Excludes:diagnostic ultrasound of peripheral vascular system (88.77)
ultrasonic angioplasty of:
non-coronary vessel (39.50)
00.09 Other therapeutic ultrasound
Excludes:ultrasonic:
fragmentation of urinary stones (59.95)
percutaneous nephrostomy with fragmentation (55.04)
physical therapy (93.35)
transurethral guided laser induced prostatectomy (TULIP) (60.21)
00.1 Pharamaceuticals
00.10 Implantation of chemotherapeutic agent
Brain wafer chemotherapy
Interstitial/ intracavitary
Excludes:injection or infusion of cancer chemotherapeutic substance (99.25)
00.11 Infusion of drotrecogin alfa (activated)
Infusion of recombinant protein
00.12 Administration of inhaled nitric oxide
Nitric oxide therapy
00.13 Injection or infusion of nesiritide
Human B-type natriuretic peptide (hBNP)
00.14 Injection or infusion of oxazolidinone class of antibiotics
Linezolid injection
00.15 High-dose infusion interleukin-2 [IL-2]
Infusion (IV bolus, CIV) interleukin
Injection of aldesleukin
Excludes: low-dose infusion interleukin-2 (99.28)
00.16 Pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance
Ex-vivo treatment of vessel
Hyperbaric pressurized graft [conduit]
00.17 Infusion of vasopressor agent
00.18 Infusion of immunosuppressive antibody therapy
Includes: during induction phase of solid organ transplantation
monoclonal antibody therapy
polyclonal antibody therapy
00.19 Disruption of blood brain barrier via infusion [BBBD]
Infusion of substance to disrupt blood brain barrier
Code also chemotherapy (99.25)
Excludes: other perfusion (39.97)
00.2 Intravascular imaging of blood vessels
Endovascular ultrasonography
Intravascular ultrasound (IVUS)
Intravascular [ultrasound] imaging of blood vessels
Virtual histology intravascular ultrasound [VH-IVUS]
Note: real-time imaging of lumen of blood vessel(s) using sound waves
Code also any synchronous diagnostic or therapeutic procedures
Excludes: adjunct vascular system procedures, number of vessels treated (00.40-00.43)
diagnostic procedures on blood vessels (38.21-38.29)
diagnostic ultrasound of peripheral vascular system (88.77)
intravascular imaging of vessel(s) by OCT (38.24-38.25)
magnetic resonance imaging (MRI) (88.91-88.97)
therapeutic ultrasound (00.01-00.09)
00.21 Intravascular imaging of extracranial cerebral vessels
Common carotid vessels and branches
Intravascular ultrasound (IVUS), extracranial cerebral vessels
Excludes: diagnostic ultrasound (non-invasive) of head and neck (88.71)
00.22 Intravascular imaging of intrathoracic vessels
Aorta and aortic arch
Intravascular ultrasound (IVUS), intrathoracic vessels
Vena cava (superior) (inferior)
Excludes: diagnostic ultrasound (non-invasive) of other sites of thorax (88.73)
00.23 Intravascular imaging of peripheral vessels
Imaging of:
vessels of arm(s)
vessels of leg(s)
Intravascular ultrasound (IVUS), peripheral vessels
Excludes: diagnostic ultrasound (non-invasive) of peripheral vascular system (88.77)
00.24 Intravascular imaging of coronary vessels
Intravascular ultrasound (IVUS), coronary vessels
Excludes: diagnostic ultrasound (non-invasive) of heart (88.72)
intracardiac echocardiography [ICE] (ultrasound of heart chamber(s)) (37.28)
00.25 Intravascular imaging of renal vessels
Intravascular ultrasound (IVUS), renal vessels
Renal artery
Excludes: diagnostic ultrasound (non-invasive) of urinary system (88.75)
00.28 Intravascular imaging, other specified vessel(s)
00.29 Intravascular imaging, unspecified vessel(s)
00.3 Computer assisted surgery [CAS]
CT-free navigation
Image guided navigation (IGN)
Image guided surgery (IGS)
Imageless navigation
That without the use of robotic(s) technology
Code also diagnostic or therapeutic procedure
Excludes: robotic assisted procedures (17.41-17.49)
stereotactic frame application only (93.59)
00.31 Computer assisted surgery with CT/CTA
00.32 Computer assisted surgery with MR/MRA
00.33 Computer assisted surgery with fluoroscopy
00.34 Imageless computer assisted surgery
00.35 Computer assisted surgery with multiple datasets
00.39 Other computer assisted surgery
Computer assisted surgery NOS
00.4 Adjunct Vascular System Procedures
Note: These codes can apply to both coronary and peripheral vessels. These codes are to be used in conjunction with other
therapeutic procedure codes to provide additional information on the number of vessels upon which a procedure
was performed and/or the number of stents inserted. As appropriate, code both the number of vessels operated
on (00.40-00.43), and the number of stents inserted (00.45-00.48).
Code also any:
angioplasty or atherectomy (00.61-00.62, 00.66, 39.50)
endarterectomy (38.10-38.18)
insertion of vascular stent(s) (00.55, 00.63-00.65, 36.06-36.07, 39.90)
other removal of coronary artery obstruction (36.09)
00.40 Procedure on single vessel
Number of vessels, unspecified
Excludes: (aorto)coronary bypass (36.10-36.19)
intravascular imaging of blood vessels (00.21-00.29)
00.41 Procedure on two vessels
Excludes: (aorto) coronary bypass (36.10-36.19)
intravascular imaging of blood vessels (00.21-00.29)
00.42 Procedure on three vessels
Excludes: (aorto) coronary bypass (36.10-36.19)
intravascular imaging of blood vessels (00.21-00.29)
00.43 Procedure on four or more vessels
Excludes: (aorto) coronary bypass (36.10-36.19)
intravascular imaging of blood vessels (00.21-00.29)
00.44 Procedure on vessel bifurcation
Note: This code is to be used to identify the presence of a vessel bifurcation; it does not describe a specific bifurcation stent. Use this code only once per operative episode, irrespective of the number of bifurcations in vessels.
00.45 Insertion of one vascular stent
Number of stents, unspecified
00.46 Insertion of two vascular stents
00.47 Insertion of three vascular stents
00.48 Insertion of four or more vascular stents
00.49 SuperSaturated oxygen therapy
Aqueous oxygen (AO) therapy
SS02
SuperOxygenation infusion therapy
Code also any: injection or infusion of thrombolytic agent (99.10)
insertion of coronary artery stent(s) (36.06-36.07)
intracoronary artery thrombolytic infusion (36.04)
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
open chest coronary artery angioplasty (36.03)
other removal of coronary obstruction (36.09)
percutaneous transluminal coronary angioplasty [PTCA] (00.66)
procedure on vessel bifurcation (00.44)
Excludes: other oxygen enrichment (93.96)
other perfusion (39.97)
00.5 Other cardiovascular procedures
00.50 Implantation of cardiac resynchronization pacemaker without mention of defibrillation, total system [CRT-P]
Biventricular pacemaker
Biventricular pacing without internal cardiac defibrillator
BiV pacemaker
Implantation of cardiac resynchronization (biventricular) pulse generator pacing device, formation of
pocket, transvenous leads including placement of lead into left ventricular coronary venous system, and
intraoperative procedures for evaluation of lead signals.
That with CRT-P generator and one or more leads
Note: Device testing during procedure - omit code
Excludes: implantation of cardiac resynchronization defibrillator, total system [CRT-D] (00.51)
insertion or replacement of any type pacemaker device (37.80-37.87)
replacement of cardiac resynchronization defibrillator pulse generator only [CRT-D](00.54)
replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P](00.53)
00.51 Implantation of cardiac resynchronization defibrillator, total system [CRT-D]
BiV defibrillator
Biventricular defibrillator
Biventricular pacing with internal cardiac defibrillator
BiV ICD
BiV pacemaker with defibrillator
BiV pacing with defibrillator
Implantation of a cardiac resynchronization (biventricular) pulse generator with defibrillator [AICD], formation
of pocket, transvenous leads, including placement of lead into left ventricular coronary venous system,
intraoperative procedures for evaluation of lead signals, and obtaining defibrillator threshold measurements.
That with CRT-D generator and one or more leads
Note: Device testing during procedure - omit code
Excludes: implantation of cardiac resynchronization pacemaker, total system [CRT-P](00.50)
implantation or replacement of automatic cardioverter/defibrillator, total system [AICD] (37.94)
replacement of cardiac resynchronization defibrillator pulse generator, only [CRT-D](00.54)
00.52 Implantation or replacement of transvenous lead [electrode] into left ventricular coronary venous system
Excludes: implantation of cardiac resynchronization defibrillator, total system [CRT-D](00.51)
implantation of cardiac resynchronization pacemaker, total system [CRT-P](00.50)
initial insertion of transvenous lead [electrode] (37.70-37.72)
replacement of transvenous atrial and/or ventricular lead(s) [electrodes] (37.76)
00.53 Implantation or replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P]
Implantation of CRT-P device with removal of any existing CRT-P or other pacemaker device
Note: Device testing during procedure - omit code
Excludes: implantation of cardiac resynchronization pacemaker, total system [CRT-P] (00.50)
implantation or replacement of cardiac resynchronization defibrillator pulse generator only [CRT-D](00.54)
insertion or replacement of any type pacemaker device (37.80-37.87)
00.54 Implantation or replacement of cardiac resynchronization defibrillator pulse generator device only [CRT-D]
Implantation of CRT-D device with removal of any existing CRT-D, CRT-P, pacemaker, or defibrillator
device
Note: Device testing during procedure - omit code
Excludes: implantation of automatic cardioverter/defibrillator pulse generator only (37.96)
implantation of cardiac resynchronization defibrillator, total system [CRT-D] (00.51)
implantation or replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P] (00.53)
00.55 Insertion of drug-eluting peripheral vessel stent(s)
Endograft(s)
Endovascular graft(s)
Stent grafts
Code also any:
angioplasty or atherectomy of other non-coronary vessel(s) (39.50)
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
procedure on vessel bifurcation (00.44)
Excludes: drug-coated peripheral stents, e.g., heparin coated (39.90)
insertion of cerebrovascular stent(s) (00.63-00.65)
insertion of drug-eluting coronary artery stent (36.07)
insertion of non-drug-eluting stent(s):
coronary artery (36.06)
peripheral vessel (39.90)
that for aneurysm repair (39.71 - 39.79)
00.56 Insertion or replacement of implantable pressure sensor (lead) for intracardiac or great vessel hemodynamic monitoring
Code also any associated implantation or replacement of monitor (00.57)
Excludes: circulatory monitoring (blood gas, arterial or venous pressure, cardiac output and coronary blood flow) (89.60 - 89.69)
00.57 Implantation or replacement of subcutaneous device for intracardiac or great vessel hemodynamic monitoring
Implantation of monitoring device with formation of subcutaneous pocket and connection to intracardiac pressure sensor (lead)
Code also any associated insertion or replacement of implanted pressure sensor (lead) (00.56)
00.58 Insertion of intra-aneurysm sac pressure monitoring device (intraoperative)
Insertion of pressure sensor during endovascular repair of abdominal or thoracic aortic aneurysm(s)
00.59 Intravascular pressure measurement of coronary arteries
Includes: fractional flow reserve (FFR)
Code also any synchronous diagnostic or therapeutic procedures
Excludes: intravascular pressure measurement of intrathoracic arteries (00.67)
00.6 Procedures on blood vessels
00.61 Percutaneous angioplasty or atherectomy of precerebral (extracranial) vessel(s)
Basilar
Carotid
Vertebral
Code also any:
injection or infusion of thrombolytic agent (99.10)
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
percutaneous insertion of carotid artery stent(s) (00.63)
percutaneous insertion of other precerebral artery stent(s) (00.64)
procedure on vessel bifurcation (00.44)
Excludes: angioplasty or atherectomy of other non-coronary vessel(s) (39.50)
removal of cerebrovascular obstruction of vessel(s) by open approach (38.01-38.02, 38.11-38.12, 38.31-38.32, 38.41-38.42)
00.62 Percutaneous angioplasty or atherectomy of intracranial vessel(s)
Code also any:
injection or infusion of thrombolytic agent (99.10)
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
percutaneous insertion of intracranial stent(s) (00.65)
procedure on vessel bifurcation (00.44)
Excludes: angioplasty or atherectomy of other non-coronary vessel(s) (39.50)
removal of cerebrovascular obstruction of vessel(s) by open approach (38.01-38.02, 38.11-38.12, 38.31-38.32, 38.41-38.42)
00.63 Percutaneous insertion of carotid artery stent(s)
Includes: the use of any embolic protection device, distal protection device, filter device, or stent delivery system
Non-drug-eluting stent
Code also any:
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
percutaneous angioplasty or atherectomy of precerebral vessel(s) (00.61)
procedure on vessel bifurcation (00.44)
Excludes: angioplasty or atherectomy of other non-coronary vessel(s)(39.50)
insertion of drug-eluting peripheral vessel stent(s) (00.55)
00.64 Percutaneous insertion of other precerebral (extracranial) artery stent(s)
Includes: the use of any embolic protection device, distal protection device, filter device, or stent delivery
system
Basilar stent
Vertebral stent
Code also any:
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
percutaneous angioplasty or atherectomy of precerebral vessel(s) (00.61)
procedure on vessel bifurcation (00.44)
Excludes: angioplasty or atherectomy of other non-coronary vessel(s)(39.50)
insertion of drug-eluting peripheral vessel stent(s) (00.55)
00.65 Percutaneous insertion of intracranial vascular stent(s)
Includes: the use of any embolic protection device, distal protection device, filter device, or stent delivery
system
Code also any:
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
percutaneous angioplasty or atherectomy of intracranial vessel(s) (00.62)
procedure on vessel bifurcation (00.44)
Excludes: angioplasty or atherectomy of other non-coronary vessel(s)(39.50)
insertion of drug-eluting peripheral vessel stent(s) (00.55)
00.66 Percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy
Balloon angioplasty of coronary artery
Coronary atherectomy
Percutaneous coronary angioplasty NOS
PTCA NOS
Code also any:
injection or infusion of thrombolytic agent (99.10)
insertion of coronary artery stent(s) (36.06-36.07)
intracoronary artery thrombolytic infusion (36.04)
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
procedure on vessel bifurcation (00.44)
SuperSaturated oxygen therapy (00.49)
00.67 Intravascular pressure measurement of intrathoracic arteries
Assessment of:
Aorta and aortic arch
Carotid
Code also any synchronous diagnostic or therapeutic procedures
00.68 Intravascular pressure measurement of peripheral arteries
Assessment of:
Other peripheral vessels
Vessels of arm(s)
Vessels of leg(s)
Code also any synchronous diagnostic or therapeutic procedures
00.69 Intravascular pressure measurement, other specified and unspecified vessels
Assessment of
Iliac vessels
Intra-abdominal vessels
Mesenteric vessels
Renal vessels
Code also any synchronous diagnostic or therapeutic procedures
Excludes: intravascular pressure measurement of:
coronary arteries (00.59)
intrathoracic arteries (00.67)
peripheral arteries (00.68)
00.7 Other hip procedures
00.70 Revision of hip replacement, both acetabular and femoral components
Total hip revision
Code also any:
removal of (cement) (joint) spacer (84.57)
type of bearing surface, if known (00.74-00.77)
Excludes:
revision of hip replacement, acetabular component only (00.71)
revision of hip replacement, femoral component only (00.72)
revision of hip replacement, Not Otherwise Specified (81.53)
revision with replacement of acetabular liner and/or femoral head only (00.73)
00.71 Revision of hip replacement, acetabular component
Partial, acetabular component only
That with:
exchange of acetabular cup and liner
exchange of femoral head
Code also any type of bearing surface, if known (00.74-00.77)
Excludes:
revision of hip replacement, both acetabular and femoral components (00.70)
revision of hip replacement, femoral component (00.72)
revision of hip replacement, Not Otherwise Specified (81.53)
revision with replacement of acetabular liner and/or femoral head only (00.73)
00.72 Revision of hip replacement, femoral component
Partial, femoral component only
That with:
exchange of acetabular liner
exchange of femoral stem and head
Code also any type of bearing surface, if known (00.74-00.77)
Excludes:
revision of hip replacement, acetabular component (00.71)
revision of hip replacement, both acetabular and femoral components (00.70)
revision of hip replacement, not otherwise specified (81.53)
revision with replacement of acetabular liner and/or femoral head only (00.73)
00.73 Revision of hip replacement, acetabular liner and/or femoral head only
Code also any type of bearing surface, if known (00.74-00.77)
00.74 Hip bearing surface, metal-on-polyethylene
00.75 Hip bearing surface, metal-on-metal
00.76 Hip bearing surface, ceramic-on-ceramic
00.77 Hip bearing surface, ceramic-on-polyethylene
00.8 Other knee and hip procedures
Note: Report up to two components using 00.81 - 00.83 to describe revision of knee replacements.  OPERATIONS ON THE NERVOUS SYSTEM (01-05)
01 Incision and excision of skull, brain, and cerebral meninges
01.0 Cranial puncture
01.01 Cisternal puncture
Cisternal tap
Excludes: pneumocisternogram (87.02)
01.02 Ventriculopuncture through previously implanted catheter
Puncture of ventricular shunt tubing
01.09 Other cranial puncture
Aspiration of:
subarachnoid space
subdural space
Cranial aspiration NOS
Puncture of anterior fontanel
Subdural tap (through fontanel)
01.1 Diagnostic procedures on skull, brain, and cerebral meninges
01.10 Intracranial pressure monitoring
Includes: insertion of catheter or probe for monitoring
01.11 Closed [percutaneous] [needle] biopsy of cerebral meninges
Burr hole approach
01.12 Open biopsy of cerebral meninges
01.13 Closed [percutaneous] [needle] biopsy of brain
Burr hole approach
Stereotactic method
01.14 Open biopsy of brain
01.15 Biopsy of skull
01.16 Intracranial oxygen monitoring
Includes: insertion of catheter or probe for monitoring
Partial pressure of brain oxygen (PbtO2)
01.17 Brain temperature monitoring
Includes: insertion of catheter or probe for monitoring
01.18 Other diagnostic procedures on brain and cerebral meninges
Excludes: brain temperature monitoring (01.17)
cerebral:
arteriography (88.41)
thermography (88.81)
contrast radiogram of brain (87.01-87.02)
echoencephalogram (88.71)
electroencephalogram (89.14)
intracranial oxygen monitoring (01.16)
intracranial pressure monitoring (01.10)
microscopic examination of specimen from nervous system and of spinal fluid (90.01-90.09)
neurologic examination (89.13)
phlebography of head and neck (88.61)
pneumoencephalogram (87.01)
radioisotope scan:
cerebral (92.11)
head NEC (92.12)
tomography of head:
C.A.T. scan (87.03)
other (87.04)
01.19 Other diagnostic procedures on skull
Excludes: transillumination of skull (89.16)
x-ray of skull (87.17)
01.2 Craniotomy and craniectomy
Excludes: decompression of skull fracture (02.02)
exploration of orbit (16.01-16.09)
that as operative approach -- omit code
01.21 Incision and drainage of cranial sinus
01.22 Removal of intracranial neurostimulator lead(s)
Code also any removal of neurostimulator pulse generator (86.05)
Excludes: removal with synchronous replacement (02.93)
01.23 Reopening of craniotomy site
01.24 Other craniotomy
Cranial:
decompression
exploration
trephination
Craniotomy NOS
Craniotomy with removal of:
epidural abscess
extradural hematoma
foreign body of skull
Excludes: removal of foreign body with incision into brain (01.39)
01.25 Other craniectomy
Debridement of skull NOS
Sequestrectomy of skull
Excludes: debridement of compound fracture of skull (02.02)
strip craniectomy (02.01)
01.26 Insertion of catheter(s) into cranial cavity or tissue
Code also any concomitant procedure (e.g. resection (01.59))
Excludes: placement of intracerebral catheter(s) via burr hole(s) (01.28)
01.27 Removal of catheter(s) from cranial cavity or tissue
01.28 Placement of intracerebral catheter(s) via burr hole(s)
Convection enhanced delivery
Stereotactic placement of intracerebral catheter(s)
Code also infusion of medication
Excludes: insertion of catheter(s) into cranial cavity or tissue(s) (01.26)
01.3 Incision of brain and cerebral meninges
01.31 Incision of cerebral meninges
Drainage of:
intracranial hygroma
subarachnoid abscess (cerebral)
subdural empyema
01.32 Lobotomy and tractotomy
Division of:
brain tissue
cerebral tracts
Percutaneous (radiofrequency) cingulotomy
01.39 Other incision of brain
Amygdalohippocampotomy
Drainage of intracerebral hematoma
Incision of brain NOS
Excludes: division of cortical adhesions (02.91)
01.4 Operations on thalamus and globus pallidus
01.41 Operations on thalamus
Chemothalamectomy
Thalamotomy
Excludes: that by stereotactic radiosurgery (92.30 - 92.39)
01.42 Operations on globus pallidus
Pallidoansectomy
Pallidotomy
Excludes: that by stereotactic radiosurgery (92.30 - 92.39)
01.5 Other excision or destruction of brain and meninges
01.51 Excision of lesion or tissue of cerebral meninges
Decortication of (cerebral) meninges
Resection of (cerebral) meninges
Stripping of subdural membrane of (cerebral) meninges
Excludes: biopsy of cerebral meninges (01.11-01.12)
01.52 Hemispherectomy
01.53 Lobectomy of brain
01.59 Other excision or destruction of lesion or tissue of brain
Curettage of brain
Debridement of brain
Marsupialization of brain cyst
Transtemporal (mastoid) excision of brain tumor
Excludes: biopsy of brain (01.13-01.14)
laser interstitial thermal therapy [LITT] of lesion or tissue of brain under guidance (17.61)
that by stereotactic radiosurgery (92.30 - 92.39)
01.6 Excision of lesion of skull
Removal of granulation tissue of cranium
Excludes: biopsy of skull (01.15)
sequestrectomy (01.25)
02 Other operations on skull, brain, and cerebral meninges
02.0 Cranioplasty
Excludes: that with synchronous repair of encephalocele (02.12)
02.01 Opening of cranial suture
Linear craniectomy
Strip craniectomy
02.02 Elevation of skull fracture fragments
Debridement of compound fracture of skull
Decompression of skull fracture
Reduction of skull fracture
Code also any synchronous debridement of brain (01.59)
Excludes: debridement of skull NOS (01.25)
removal of granulation tissue of cranium (01.6)
02.03 Formation of cranial bone flap
Repair of skull with flap
02.04 Bone graft to skull
Pericranial graft (autogenous) (heterogenous)
02.05 Insertion of skull plate
Replacement of skull plate
02.06 Other cranial osteoplasty
Repair of skull NOS
Revision of bone flap of skull
02.07 Removal of skull plate
Excludes: removal with synchronous replacement (02.05)
02.1 Repair of cerebral meninges
Excludes: marsupialization of cerebral lesion (01.59)
02.11 Simple suture of dura mater of brain
02.12 Other repair of cerebral meninges
Closure of fistula of cerebrospinal fluid
Dural graft
Repair of encephalocele including synchronous cranioplasty
Repair of meninges NOS
Subdural patch
02.13 Ligation of meningeal vessel
Ligation of:
longitudinal sinus
middle meningeal artery
02.14 Choroid plexectomy
Cauterization of choroid plexus
02.2 Ventriculostomy
Anastomosis of ventricle to:
cervical subarachnoid space
cisterna magna
Insertion of Holter valve
Ventriculocisternal intubation
02.3 Extracranial ventricular shunt
Includes: that with insertion of valve
02.31 Ventricular shunt to structure in head and neck
Ventricle to nasopharynx shunt
Ventriculomastoid anastomosis
02.32 Ventricular shunt to circulatory system
Ventriculoatrial anastomosis
Ventriculocaval shunt
02.33 Ventricular shunt to thoracic cavity
Ventriculopleural anastomosis
02.34 Ventricular shunt to abdominal cavity and organs
Ventriculocholecystostomy
Ventriculoperitoneostomy
02.35 Ventricular shunt to urinary system
Ventricle to ureter shunt
02.39 Other operations to establish drainage of ventricle
Ventricle to bone marrow shunt
Ventricular shunt to extracranial site NEC
02.4 Revision, removal, and irrigation of ventricular shunt
Excludes: revision of distal catheter of ventricular shunt (54.95)
02.41 Irrigation and exploration of ventricular shunt
Exploration of ventriculoperitoneal shunt at ventricular site
Re-programming of ventriculoperitoneal shunt
02.42 Replacement of ventricular shunt
Reinsertion of Holter valve
Replacement of ventricular catheter
Revision of ventriculoperitoneal shunt at ventricular site
02.43 Removal of ventricular shunt
02.9 Other operations on skull, brain, and cerebral meninges
Excludes: operations on:
pineal gland (07.17, 07.51-07.59)
pituitary gland [hypophysis] (07.13-07.15, 07.61-07.79)
02.91 Lysis of cortical adhesions
02.92 Repair of brain
02.93 Implantation or replacement of intracranial neurostimulator lead(s)
Implantation, insertion, placement, or replacement of intracranial:
brain pacemaker [neuropacemaker]
depth electrodes
epidural pegs
electroencephalographic receiver
foramen ovale electrodes
intracranial electrostimulator
subdural grids
subdural strips
Code also any insertion of neurostimulator pulse generator (86.94-86.98)
02.94 Insertion or replacement of skull tongs or halo traction device
02.95 Removal of skull tongs or halo traction device
02.96 Insertion of sphenoidal electrodes
02.99 Other
Excludes: chemical shock therapy (94.24)
electroshock therapy:
subconvulsive (94.26)
other (94.27)
03 Operations on spinal cord and spinal canal structures
Code also any application or administration of an adhesion barrier substance (99.77)
03.0 Exploration and decompression of spinal canal structures
03.01 Removal of foreign body from spinal canal
03.02 Reopening of laminectomy site
03.09 Other exploration and decompression of spinal canal
Decompression:
laminectomy
laminotomy
Expansile laminoplasty
Exploration of spinal nerve root
Foraminotomy
Code also any synchronous insertion, replacement and revision of posterior
spinal motion preservation device(s), if performed (84.80 - 84.85)
Excludes: drainage of spinal fluid by anastomosis (03.71-03.79)
laminectomy with excision of intervertebral disc (80.51)
spinal tap (03.31)
that as operative approach -- omit code
03.1 Division of intraspinal nerve root
Rhizotomy
03.2 Chordotomy
03.21 Percutaneous chordotomy
Stereotactic chordotomy
03.29 Other chordotomy
Chordotomy NOS
Tractotomy (one-stage) (two-stage) of spinal cord
Transection of spinal cord tracts
03.3 Diagnostic procedures on spinal cord and spinal canal structures
03.31 Spinal tap
Lumbar puncture for removal of dye
Excludes: lumbar puncture for injection of dye [myelogram] (87.21)
03.32 Biopsy of spinal cord or spinal meninges
03.39 Other diagnostic procedures on spinal cord and spinal canal structures
Excludes: microscopic examination of specimen from nervous system or of spinal fluid (90.01-90.09)
x-ray of spine (87.21-87.29)
03.4 Excision or destruction of lesion of spinal cord or spinal meninges
Curettage of spinal cord or spinal meninges
Debridement of spinal cord or spinal meninges
Marsupialization of cyst of spinal cord or spinal meninges
Resection of spinal cord or spinal meninges
Excludes: biopsy of spinal cord or meninges (03.32)
03.5 Plastic operations on spinal cord structures
03.51 Repair of spinal meningocele
Repair of meningocele NOS
03.52 Repair of spinal myelomeningocele
03.53 Repair of vertebral fracture
Elevation of spinal bone fragments
Reduction of fracture of vertebrae
Removal of bony spicules from spinal canal
Excludes: percutaneous vertebral augmentation (81.66)
percutaneous vertebroplasty (81.65)
03.59 Other repair and plastic operations on spinal cord structures
Repair of:
diastematomyelia
spina bifida NOS
spinal cord NOS
spinal meninges NOS
vertebral arch defect
03.6 Lysis of adhesions of spinal cord and nerve roots
03.7 Shunt of spinal theca
Includes: that with valve
03.71 Spinal subarachnoid-peritoneal shunt
03.72 Spinal subarachnoid-ureteral shunt
03.79 Other shunt of spinal theca
Lumbar-subarachnoid shunt NOS
Pleurothecal anastomosis
Salpingothecal anastomosis
03.8 Injection of destructive agent into spinal canal
03.9 Other operations on spinal cord and spinal canal structures
03.90 Insertion of catheter into spinal canal for infusion of therapeutic or palliative substances
Insertion of catheter into epidural, subarachnoid, or subdural space of spine with intermittent or continuous infusion of drug (with creation of any reservoir)
Code also any implantation of infusion pump (86.06)
03.91 Injection of anesthetic into spinal canal for analgesia
Excludes: that for operative anesthesia -- omit code
03.92 Injection of other agent into spinal canal
Intrathecal injection of steroid
Subarachnoid perfusion of refrigerated saline
Excludes: injection of:
contrast material for myelogram (87.21)
destructive agent into spinal canal (03.8)
03.93 Implantation or replacement of spinal neurostimulator lead(s)
Code also any insertion of neurostimulator pulse generator (86.94-86.98)
03.94 Removal of spinal neurostimulator lead(s)
Code also any removal of neurostimulator pulse generator (86.05)
03.95 Spinal blood patch
03.96 Percutaneous denervation of facet
03.97 Revision of spinal thecal shunt
03.98 Removal of spinal thecal shunt
03.99 Other
04 Operations on cranial and peripheral nerves
04.0 Incision, division, and excision of cranial and peripheral nerves
Excludes: opticociliary neurectomy (12.79)
sympathetic ganglionectomy (05.21-05.29)
04.01 Excision of acoustic neuroma
That by craniotomy
Excludes: that by stereotactic radiosurgery (92.30 - 92.39)
04.02 Division of trigeminal nerve
Retrogasserian neurotomy
04.03 Division or crushing of other cranial and peripheral nerves
Excludes: that of:
glossopharyngeal nerve (29.92)
laryngeal nerve (31.91)
nerves to adrenal glands (07.42)
phrenic nerve for collapse of lung (33.31)
vagus nerve (44.00-44.03)
04.04 Other incision of cranial and peripheral nerves
04.05 Gasserian ganglionectomy
04.06 Other cranial or peripheral ganglionectomy
Excludes: sympathetic ganglionectomy (05.21-05.29)
04.07 Other excision or avulsion of cranial and peripheral nerves
Curettage of peripheral nerve
Debridement of peripheral nerve
Resection of peripheral nerve
Excision of peripheral neuroma [Morton's]
Excludes: biopsy of cranial or peripheral nerve (04.11-04.12)
04.1 Diagnostic procedures on peripheral nervous system
04.11 Closed [percutaneous] [needle] biopsy of cranial or peripheral nerve or ganglion
04.12 Open biopsy of cranial or peripheral nerve or ganglion
04.19 Other diagnostic procedures on cranial and peripheral nerves and ganglia
Excludes: microscopic examination of specimen from nervous system (90.01-90.09)
neurologic examination (89.13)
04.2 Destruction of cranial and peripheral nerves
Destruction of cranial or peripheral nerves by:
cryoanalgesia
injection of neurolytic agent
radiofrequency
Radiofrequency ablation
04.3 Suture of cranial and peripheral nerves
04.4 Lysis of adhesions and decompression of cranial and peripheral nerves
04.41 Decompression of trigeminal nerve root
04.42 Other cranial nerve decompression
04.43 Release of carpal tunnel
04.44 Release of tarsal tunnel
04.49 Other peripheral nerve or ganglion decompression or lysis of adhesions
Peripheral nerve neurolysis NOS
04.5 Cranial or peripheral nerve graft
04.6 Transposition of cranial and peripheral nerves
Nerve transplantation
04.7 Other cranial or peripheral neuroplasty
04.71 Hypoglossal-facial anastomosis
04.72 Accessory-facial anastomosis
04.73 Accessory-hypoglossal anastomosis
04.74 Other anastomosis of cranial or peripheral nerve
04.75 Revision of previous repair of cranial and peripheral nerves
04.76 Repair of old traumatic injury of cranial and peripheral nerves
04.79 Other neuroplasty
04.8 Injection into peripheral nerve
Excludes: destruction of nerve (by injection of neurolytic agent) (04.2)
04.80 Peripheral nerve injection, not otherwise specified
04.81 Injection of anesthetic into peripheral nerve for analgesia
Excludes: that for operative anesthesia -- omit code
04.89 Injection of other agent, except neurolytic
Excludes: injection of neurolytic agent (04.2)
04.9 Other operations on cranial and peripheral nerves
04.91 Neurectasis
04.92 Implantation or replacement of peripheral neurostimulator lead(s)
Code also any insertion of neurostimulator pulse generator (86.94-86.98)
04.93 Removal of peripheral neurostimulator lead(s)
Code also any removal of neurostimulator pulse generator (86.05)
04.99 Other
05 Operations on sympathetic nerves or ganglia
Excludes: paracervical uterine denervation (69.3)
05.0 Division of sympathetic nerve or ganglion
Excludes: that of nerves to adrenal glands (07.42)
05.1 Diagnostic procedures on sympathetic nerves or ganglia
05.11 Biopsy of sympathetic nerve or ganglion
05.19 Other diagnostic procedures on sympathetic nerves or ganglia
05.2 Sympathectomy
05.21 Sphenopalatine ganglionectomy
05.22 Cervical sympathectomy
05.23 Lumbar sympathectomy
05.24 Presacral sympathectomy
05.25 Periarterial sympathectomy
05.29 Other sympathectomy and ganglionectomy
Excision or avulsion of sympathetic nerve NOS
Sympathetic ganglionectomy NOS
Excludes: biopsy of sympathetic nerve or ganglion (05.11)
opticociliary neurectomy (12.79)
periarterial sympathectomy (05.25)
tympanosympathectomy (20.91)
05.3 Injection into sympathetic nerve or ganglion
Excludes: injection of ciliary sympathetic ganglion (12.79)
05.31 Injection of anesthetic into sympathetic nerve for analgesia
05.32 Injection of neurolytic agent into sympathetic nerve
05.39 Other injection into sympathetic nerve or ganglion
05.8 Other operations on sympathetic nerves or ganglia
05.81 Repair of sympathetic nerve or ganglion
05.89 Other
05.9 Other operations on nervous system
2. OPERATIONS ON THE ENDOCRINE SYSTEM (06-07)
06 Operations on thyroid and parathyroid glands
Includes: incidental resection of hyoid bone
06.0 Incision of thyroid field
Excludes: division of isthmus (06.91)
06.01 Aspiration of thyroid field
Percutaneous or needle drainage of thyroid field
Excludes: aspiration biopsy of thyroid (06.11)
drainage by incision (06.09)
postoperative aspiration of field (06.02)
06.02 Reopening of wound of thyroid field
Reopening of wound of thyroid field for:
control of (postoperative) hemorrhage
examination
exploration
removal of hematoma
06.09 Other incision of thyroid field
Drainage of hematoma by incision
Drainage of thyroglossal tract by incision
Exploration:
neck by incision
thyroid (field) by incision
Removal of foreign body by incision
Thyroidotomy NOS by incision
Excludes: postoperative exploration (06.02)
removal of hematoma by aspiration (06.01)
06.1 Diagnostic procedures on thyroid and parathyroid glands
06.11 Closed [percutaneous] [needle] biopsy of thyroid gland
Aspiration biopsy of thyroid
06.12 Open biopsy of thyroid gland
06.13 Biopsy of parathyroid gland
06.19 Other diagnostic procedures on thyroid and parathyroid glands
Excludes: radioisotope scan of:
parathyroid (92.13)
thyroid (92.01)
soft tissue x-ray of thyroid field (87.09)
06.2 Unilateral thyroid lobectomy
Complete removal of one lobe of thyroid (with removal of isthmus or portion of other lobe)
Hemithyroidectomy
Excludes: partial substernal thyroidectomy (06.51)
06.3 Other partial thyroidectomy
06.31 Excision of lesion of thyroid
Excludes: biopsy of thyroid (06.11-06.12)
laser interstitial thermal therapy [LITT] of lesion or tissue of neck under guidance (17.62)
06.39 Other
Isthmectomy
Partial thyroidectomy NOS
Excludes: partial substernal thyroidectomy (06.51)
06.4 Complete thyroidectomy
Excludes: complete substernal thyroidectomy (06.52)
that with laryngectomy (30.3-30.4)
06.5 Substernal thyroidectomy
06.50 Substernal thyroidectomy, not otherwise specified
06.51 Partial substernal thyroidectomy
06.52 Complete substernal thyroidectomy
06.6 Excision of lingual thyroid
Excision of thyroid by:
submental route
transoral route
06.7 Excision of thyroglossal duct or tract
06.8 Parathyroidectomy
06.81 Complete parathyroidectomy
06.89 Other parathyroidectomy
Parathyroidectomy NOS
Partial parathyroidectomy
Excludes: biopsy of parathyroid (06.13)
06.9 Other operations on thyroid (region) and parathyroid
06.91 Division of thyroid isthmus
Transection of thyroid isthmus
06.92 Ligation of thyroid vessels
06.93 Suture of thyroid gland
06.94 Thyroid tissue reimplantation
Autotransplantation of thyroid tissue
06.95 Parathyroid tissue reimplantation
Autotransplantation of parathyroid tissue
06.98 Other operations on thyroid glands
06.99 Other operations on parathyroid glands
07 Operations on other endocrine glands
Includes: operations on:
adrenal glands
pineal gland
pituitary gland
thymus
Excludes: operations on:
aortic and carotid bodies (39.8)
ovaries (65.0-65.99)
pancreas (52.01-52.99)
testes (62.0-62.99)
07.0 Exploration of adrenal field
Excludes: incision of adrenal (gland) (07.41)
07.00 Exploration of adrenal field, not otherwise specified
07.01 Unilateral exploration of adrenal field
07.02 Bilateral exploration of adrenal field
07.1 Diagnostic procedures on adrenal glands, pituitary gland, pineal gland, and thymus
07.11 Closed [percutaneous] [needle] biopsy of adrenal gland
07.12 Open biopsy of adrenal gland
07.13 Biopsy of pituitary gland, transfrontal approach
07.14 Biopsy of pituitary gland, transsphenoidal approach
07.15 Biopsy of pituitary gland, unspecified approach
07.16 Biopsy of thymus
07.17 Biopsy of pineal gland
07.19 Other diagnostic procedures on adrenal glands, pituitary gland, pineal gland, and thymus
Excludes: microscopic examination of specimen from endocrine gland (90.11-90.19)
radioisotope scan of pituitary gland (92.11)
07.2 Partial adrenalectomy
07.21 Excision of lesion of adrenal gland
Excludes: biopsy of adrenal gland (07.11-07.12)
07.22 Unilateral adrenalectomy
Adrenalectomy NOS
Excludes: excision of remaining adrenal gland (07.3)
07.29 Other partial adrenalectomy
Partial adrenalectomy NOS
07.3 Bilateral adrenalectomy
Excision of remaining adrenal gland
Excludes: bilateral partial adrenalectomy (07.29)
07.4 Other operations on adrenal glands, nerves, and vessels
07.41 Incision of adrenal gland
Adrenalotomy (with drainage)
07.42 Division of nerves to adrenal glands
07.43 Ligation of adrenal vessels
07.44 Repair of adrenal gland
07.45 Reimplantation of adrenal tissue
Autotransplantation of adrenal tissue
07.49 Other
07.5 Operations on pineal gland
07.51 Exploration of pineal field
Excludes: that with incision of pineal gland (07.52)
07.52 Incision of pineal gland
07.53 Partial excision of pineal gland
Excludes: biopsy of pineal gland (07.17)
07.54 Total excision of pineal gland
Pinealectomy (complete) (total)
07.59 Other operations on pineal gland
07.6 Hypophysectomy
07.61 Partial excision of pituitary gland, transfrontal approach
Cryohypophysectomy, partial transfrontal approach
Division of hypophyseal stalk transfrontal approach
Excision of lesion of pituitary [hypophysis] transfrontal approach
Hypophysectomy, subtotal transfrontal approach
Infundibulectomy, hypophyseal transfrontal approach
Excludes: biopsy of pituitary gland, transfrontal approach (07.13)
07.62 Partial excision of pituitary gland, transsphenoidal approach
Excludes: biopsy of pituitary gland, transsphenoidal approach (07.14)
07.63 Partial excision of pituitary gland, unspecified approach
Excludes: biopsy of pituitary gland NOS (07.15)
07.64 Total excision of pituitary gland, transfrontal approach
Ablation of pituitary by implantation (strontium-yttrium) (Y) transfrontal approach
Cryohypophysectomy, complete transfrontal approach
07.65 Total excision of pituitary gland, transsphenoidal approach
07.68 Total excision of pituitary gland, other specified approach
07.69 Total excision of pituitary gland, unspecified approach
Hypophysectomy NOS
Pituitectomy NOS
07.7 Other operations on hypophysis
07.71 Exploration of pituitary fossa
Excludes: exploration with incision of pituitary gland (07.72)
07.72 Incision of pituitary gland
Aspiration of:
craniobuccal pouch
craniopharyngioma
hypophysis
pituitary gland
Rathke's pouch
07.79 Other
Insertion of pack into sella turcica
07.8 Thymectomy
07.80 Thymectomy, not otherwise specified
07.81 Other partial excision of thymus
Open partial excision of thymus
Excludes: biopsy of thymus (07.16)
thoracoscopic partial excision of thymus (07.83)
07.82 Other total excision of thymus
Open total excision of thymus
Excludes: thoracoscopic total excision of thymus (07.84)
07.83 Thoracoscopic partial excision of thymus
Excludes: other partial excision of thymus (07.81)
07.84 Thoracoscopic total excision of thymus
Excludes: other total excision of thymus (07.82)
07.9 Other operations on thymus
07.91 Exploration of thymus field
Excludes: exploration with incision of thymus (07.92)
07.92 Other incision of thymus
Open incision of thymus
Excludes: thoracoscopic incision of thymus (07.95)
07.93 Repair of thymus
07.94 Transplantation of thymus
07.95 Thoracoscopic incision of thymus
Excludes: other incision of thymus (07.92)
07.98 Other and unspecified thoracoscopic operations on thymus
07.99 Other and unspecified operations on thymus
Transcervical thymectomy
Excludes: other thoracoscopic operations on thymus (07.98)
3. OPERATIONS ON THE EYE (08-16)
08 Operations on eyelids
Includes: operations on the eyebrow
08.0 Incision of eyelid
08.01 Incision of lid margin
08.02 Severing of blepharorrhaphy
08.09 Other incision of eyelid
08.1 Diagnostic procedures on eyelid
08.11 Biopsy of eyelid
08.19 Other diagnostic procedures on eyelid
08.2 Excision or destruction of lesion or tissue of eyelid
Code also any synchronous reconstruction (08.61-08.74)
Excludes: biopsy of eyelid (08.11)
08.20 Removal of lesion of eyelid, not otherwise specified
Removal of meibomian gland NOS
08.21 Excision of chalazion
08.22 Excision of other minor lesion of eyelid
Excision of:
verucca
wart
08.23 Excision of major lesion of eyelid, partial-thickness
Excision involving one-fourth or more of lid margin, partial-thickness
08.24 Excision of major lesion of eyelid, full-thickness
Excision involving one-fourth or more of lid margin, full-thickness
Wedge resection of eyelid
08.25 Destruction of lesion of eyelid
08.3 Repair of blepharoptosis and lid retraction
08.31 Repair of blepharoptosis by frontalis muscle technique with suture
08.32 Repair of blepharoptosis by frontalis muscle technique with fascial sling
08.33 Repair of blepharoptosis by resection or advancement of levator muscle or aponeurosis
08.34 Repair of blepharoptosis by other levator muscle techniques
08.35 Repair of blepharoptosis by tarsal technique
08.36 Repair of blepharoptosis by other techniques
Correction of eyelid ptosis NOS
Orbicularis oculi muscle sling for correction of blepharoptosis
08.37 Reduction of overcorrection of ptosis
08.38 Correction of lid retraction
08.4 Repair of entropion or ectropion
08.41 Repair of entropion or ectropion by thermocauterization
08.42 Repair of entropion or ectropion by suture technique
08.43 Repair of entropion or ectropion with wedge resection
08.44 Repair of entropion or ectropion with lid reconstruction
08.49 Other repair of entropion or ectropion
08.5 Other adjustment of lid position
08.51 Canthotomy
Enlargement of palpebral fissure
08.52 Blepharorrhaphy
Canthorrhaphy
Tarsorrhaphy
08.59 Other
Canthoplasty NOS
Repair of epicanthal fold
08.6 Reconstruction of eyelid with flaps or grafts
Excludes: that associated with repair of entropion and ectropion (08.44)
08.61 Reconstruction of eyelid with skin flap or graft
08.62 Reconstruction of eyelid with mucous membrane flap or graft
08.63 Reconstruction of eyelid with hair follicle graft
08.64 Reconstruction of eyelid with tarsoconjunctival flap
Transfer of tarsoconjunctival flap from opposing lid
08.69 Other reconstruction of eyelid with flaps or grafts
08.7 Other reconstruction of eyelid
Excludes: that associated with repair of entropion and ectropion (08.44)
08.70 Reconstruction of eyelid, not otherwise specified
08.71 Reconstruction of eyelid involving lid margin, partial-thickness
08.72 Other reconstruction of eyelid, partial-thickness
08.73 Reconstruction of eyelid involving lid margin, full-thickness
08.74 Other reconstruction of eyelid, full-thickness
08.8 Other repair of eyelid
08.81 Linear repair of laceration of eyelid or eyebrow
08.82 Repair of laceration involving lid margin, partial-thickness
08.83 Other repair of laceration of eyelid, partial-thickness
08.84 Repair of laceration involving lid margin, full-thickness
08.85 Other repair of laceration of eyelid, full-thickness
08.86 Lower eyelid rhytidectomy
08.87 Upper eyelid rhytidectomy
08.89 Other eyelid repair
08.9 Other operations on eyelids
08.91 Electrosurgical epilation of eyelid
08.92 Cryosurgical epilation of eyelid
08.93 Other epilation of eyelid
08.99 Other
09 Operations on lacrimal system
09.0 Incision of lacrimal gland
Incision of lacrimal cyst (with drainage)
09.1 Diagnostic procedures on lacrimal system
09.11 Biopsy of lacrimal gland
09.12 Biopsy of lacrimal sac
09.19 Other diagnostic procedures on lacrimal system
Excludes: contrast dacryocystogram (87.05)
soft tissue x-ray of nasolacrimal duct (87.09)
09.2 Excision of lesion or tissue of lacrimal gland
09.20 Excision of lacrimal gland, not otherwise specified
09.21 Excision of lesion of lacrimal gland
Excludes: biopsy of lacrimal gland (09.11)
09.22 Other partial dacryoadenectomy
Excludes: biopsy of lacrimal gland (09.11)
09.23 Total dacryoadenectomy
09.3 Other operations on lacrimal gland
09.4 Manipulation of lacrimal passage
Includes: removal of calculus
that with dilation
Excludes: contrast dacryocystogram (87.05)
09.41 Probing of lacrimal punctum
09.42 Probing of lacrimal canaliculi
09.43 Probing of nasolacrimal duct
Excludes: that with insertion of tube or stent (09.44)
09.44 Intubation of nasolacrimal duct
Insertion of stent into nasolacrimal duct
09.49 Other manipulation of lacrimal passage
09.5 Incision of lacrimal sac and passages
09.51 Incision of lacrimal punctum
09.52 Incision of lacrimal canaliculi
09.53 Incision of lacrimal sac
09.59 Other incision of lacrimal passages
Incision (and drainage) of nasolacrimal duct NOS
09.6 Excision of lacrimal sac and passage
Excludes: biopsy of lacrimal sac (09.12)
09.7 Repair of canaliculus and punctum
Excludes: repair of eyelid (08.81-08.89)
09.71 Correction of everted punctum
09.72 Other repair of punctum
09.73 Repair of canaliculus
09.8 Fistulization of lacrimal tract to nasal cavity
09.81 Dacryocystorhinostomy [DCR]
09.82 Conjunctivocystorhinostomy
Conjunctivodacryocystorhinostomy [CDCR]
Excludes: that with insertion of tube or stent (09.83)
09.83 Conjunctivorhinostomy with insertion of tube or stent
09.9 Other operations on lacrimal system
09.91 Obliteration of lacrimal punctum
09.99 Other
10 Operations on conjunctiva
10.0 Removal of embedded foreign body from conjunctiva by incision
Excludes: removal of:
embedded foreign body without incision (98.22)
superficial foreign body (98.21)
10.1 Other incision of conjunctiva
10.2 Diagnostic procedures on conjunctiva
10.21 Biopsy of conjunctiva
10.29 Other diagnostic procedures on conjunctiva
10.3 Excision or destruction of lesion or tissue of conjunctiva
10.31 Excision of lesion or tissue of conjunctiva
Excision of ring of conjunctiva around cornea
Excludes: biopsy of conjunctiva (10.21)
10.32 Destruction of lesion of conjunctiva
Excludes: excision of lesion (10.31)
thermocauterization for entropion (08.41)
10.33 Other destructive procedures on conjunctiva
Removal of trachoma follicles
10.4 Conjunctivoplasty
10.41 Repair of symblepharon with free graft
10.42 Reconstruction of conjunctival cul-de-sac with free graft
Excludes: revision of enucleation socket with graft (16.63)
10.43 Other reconstruction of conjunctival cul-de-sac
Excludes: revision of enucleation socket (16.64)
10.44 Other free graft to conjunctiva
10.49 Other conjunctivoplasty
Excludes: repair of cornea with conjunctival flap (11.53)
10.5 Lysis of adhesions of conjunctiva and eyelid
Division of symblepharon (with insertion of conformer)
10.6 Repair of laceration of conjunctiva
Excludes: that with repair of sclera (12.81)
10.9 Other operations on conjunctiva
10.91 Subconjunctival injection
10.99 Other
11 Operations on cornea
11.0 Magnetic removal of embedded foreign body from cornea
Excludes: that with incision (11.1)
11.1 Incision of cornea
Incision of cornea for removal of foreign body
11.2 Diagnostic procedures on cornea
11.21 Scraping of cornea for smear or culture
11.22 Biopsy of cornea
11.29 Other diagnostic procedures on cornea
11.3 Excision of pterygium
11.31 Transposition of pterygium
11.32 Excision of pterygium with corneal graft
11.39 Other excision of pterygium
11.4 Excision or destruction of tissue or other lesion of cornea
11.41 Mechanical removal of corneal epithelium
That by chemocauterization
Excludes: that for smear or culture (11.21)
11.42 Thermocauterization of corneal lesion
11.43 Cryotherapy of corneal lesion
11.49 Other removal or destruction of corneal lesion
Excision of cornea NOS
Excludes: biopsy of cornea (11.22)
11.5 Repair of cornea
11.51 Suture of corneal laceration
11.52 Repair of postoperative wound dehiscence of cornea
11.53 Repair of corneal laceration or wound with conjunctival flap
11.59 Other repair of cornea
11.6 Corneal transplant
Excludes: excision of pterygium with corneal graft (11.32)
11.60 Corneal transplant, not otherwise specified
Keratoplasty NOS
Note: To report donor source - see codes 00.91-00.93
11.61 Lamellar keratoplasty with autograft
11.62 Other lamellar keratoplasty
11.63 Penetrating keratoplasty with autograft
Perforating keratoplasty with autograft
11.64 Other penetrating keratoplasty
Perforating keratoplasty (with homograft)
11.69 Other corneal transplant
11.7 Other reconstructive and refractive surgery on cornea
11.71 Keratomileusis
11.72 Keratophakia
11.73 Keratoprosthesis
11.74 Thermokeratoplasty
11.75 Radial keratotomy
11.76 Epikeratophakia
11.79 Other
11.9 Other operations on cornea
11.91 Tattooing of cornea
11.92 Removal of artificial implant from cornea
11.99 Other
12 Operations on iris, ciliary body, sclera, and anterior chamber
Excludes: operations on cornea (11.0-11.99)
12.0 Removal of intraocular foreign body from anterior segment of eye
12.00 Removal of intraocular foreign body from anterior segment of eye, not otherwise specified
12.01 Removal of intraocular foreign body from anterior segment of eye with use of magnet
12.02 Removal of intraocular foreign body from anterior segment of eye without use of magnet
12.1 Iridotomy and simple iridectomy
Excludes: iridectomy associated with:
cataract extraction (13.11-13.69)
removal of lesion (12.41-12.42)
scleral fistulization (12.61-12.69)
12.11 Iridotomy with transfixion
12.12 Other iridotomy
Corectomy
Discission of iris
Iridotomy NOS
12.13 Excision of prolapsed iris
12.14 Other iridectomy
Iridectomy (basal) (peripheral) (total)
12.2 Diagnostic procedures on iris, ciliary body, sclera, and anterior chamber
12.21 Diagnostic aspiration of anterior chamber of eye
12.22 Biopsy of iris
12.29 Other diagnostic procedures on iris, ciliary body, sclera, and anterior chamber
12.3 Iridoplasty and coreoplasty
12.31 Lysis of goniosynechiae
Lysis of goniosynechiae by injection of air or liquid
12.32 Lysis of other anterior synechiae
Lysis of anterior synechiae:
NOS
by injection of air or liquid
12.33 Lysis of posterior synechiae
Lysis of iris adhesions NOS
12.34 Lysis of corneovitreal adhesions
12.35 Coreoplasty
Needling of pupillary membrane
12.39 Other iridoplasty
12.4 Excision or destruction of lesion of iris and ciliary body
12.40 Removal of lesion of anterior segment of eye, not otherwise specified
12.41 Destruction of lesion of iris, nonexcisional
Destruction of lesion of iris by:
cauterization
cryotherapy
photocoagulation
12.42 Excision of lesion of iris
Excludes: biopsy of iris (12.22)
12.43 Destruction of lesion of ciliary body, nonexcisional
12.44 Excision of lesion of ciliary body
12.5 Facilitation of intraocular circulation
12.51 Goniopuncture without goniotomy
12.52 Goniotomy without goniopuncture
12.53 Goniotomy with goniopuncture
12.54 Trabeculotomy ab externo
12.55 Cyclodialysis
12.59 Other facilitation of intraocular circulation
12.6 Scleral fistulization
Excludes: exploratory sclerotomy (12.89)
12.61 Trephination of sclera with iridectomy
12.62 Thermocauterization of sclera with iridectomy
12.63 Iridencleisis and iridotasis
12.64 Trabeculectomy ab externo
12.65 Other scleral fistulization with iridectomy
12.66 Postoperative revision of scleral fistulization procedure
Revision of filtering bleb
Excludes: repair of fistula (12.82)
12.69 Other fistulizing procedure
12.7 Other procedures for relief of elevated intraocular pressure
12.71 Cyclodiathermy
12.72 Cyclocryotherapy
12.73 Cyclophotocoagulation
12.74 Diminution of ciliary body, not otherwise specified
12.79 Other glaucoma procedures
12.8 Operations on sclera
Excludes: those associated with:
retinal reattachment (14.41-14.59)
scleral fistulization (12.61-12.69)
12.81 Suture of laceration of sclera
Suture of sclera with synchronous repair of conjunctiva
12.82 Repair of scleral fistula
Excludes: postoperative revision of scleral fistulization procedure (12.66)
12.83 Revision of operative wound of anterior segment, not elsewhere classified
Excludes: postoperative revision of scleral fistulization procedure (12.66)
12.84 Excision or destruction of lesion of sclera
12.85 Repair of scleral staphyloma with graft
12.86 Other repair of scleral staphyloma
12.87 Scleral reinforcement with graft
12.88 Other scleral reinforcement
12.89 Other operations on sclera
Exploratory sclerotomy
12.9 Other operations on iris, ciliary body, and anterior chamber
12.91 Therapeutic evacuation of anterior chamber
Paracentesis of anterior chamber
Excludes: diagnostic aspiration (12.21)
12.92 Injection into anterior chamber
Injection of:
air into anterior chamber
liquid into anterior chamber
medication into anterior chamber
12.93 Removal or destruction of epithelial downgrowth from anterior chamber
Excludes: that with iridectomy (12.41-12.42)
12.97 Other operations on iris
12.98 Other operations on ciliary body
12.99 Other operations on anterior chamber
13 Operations on lens
13.0 Removal of foreign body from lens
Excludes: removal of pseudophakos (13.8)
13.00 Removal of foreign body from lens, not otherwise specified
13.01 Removal of foreign body from lens with use of magnet
13.02 Removal of foreign body from lens without use of magnet
13.1 Intracapsular extraction of lens
Code also any synchronous insertion of pseudophakos (13.71)
13.11 Intracapsular extraction of lens by temporal inferior route
13.19 Other intracapsular extraction of lens
Cataract extraction NOS
Cryoextraction of lens
Erysiphake extraction of cataract
Extraction of lens NOS
13.2 Extracapsular extraction of lens by linear extraction technique
Code also any synchronous insertion of pseudophakos (13.71)
13.3 Extracapsular extraction of lens by simple aspiration (and irrigation) technique
Irrigation of traumatic cataract
Code also any synchronous insertion of pseudophakos (13.71)
13.4 Extracapsular extraction of lens by fragmentation and aspiration technique
Code also any synchronous insertion of pseudophakos (13.71)
13.41 Phacoemulsification and aspiration of cataract
13.42 Mechanical phacofragmentation and aspiration of cataract by posterior route
Code also any synchronous vitrectomy (14.74)
13.43 Mechanical phacofragmentation and other aspiration of cataract
13.5 Other extracapsular extraction of lens
Code also any synchronous insertion of pseudophakos (13.71)
13.51 Extracapsular extraction of lens by temporal inferior route
13.59 Other extracapsular extraction of lens
13.6 Other cataract extraction
Code also any synchronous insertion of pseudophakos (13.71)
13.64 Discission of secondary membrane [after cataract]
13.65 Excision of secondary membrane [after cataract] Capsulectomy
13.66 Mechanical fragmentation of secondary membrane [after cataract]
13.69 Other cataract extraction
13.7 Insertion of prosthetic lens [pseudophakos]
Excludes: implantation of intraocular telescope prosthesis (13.91)
13.70 Insertion of pseudophakos, not otherwise specified
13.71 Insertion of intraocular lens prosthesis at time of cataract extraction, one-stage
Code also synchronous extraction of cataract (13.11-13.69)
13.72 Secondary insertion of intraocular lens prosthesis
13.8 Removal of implanted lens
Removal of pseudophakos
13.9 Other operations on lens
13.90 Operation on lens, Not Elsewhere Classified
13.91 Implantation of intraocular telescope prosthesis
Implantable miniature telescope
Includes: removal of lens, any method
Excludes: secondary insertion of ocular implant (16.61)
14 Operations on retina, choroid, vitreous, and posterior chamber
14.0 Removal of foreign body from posterior segment of eye
Excludes: removal of surgically implanted material (14.6)
14.00 Removal of foreign body from posterior segment of eye, not otherwise specified
14.01 Removal of foreign body from posterior segment of eye with use of magnet
14.02 Removal of foreign body from posterior segment of eye without use of magnet
14.1 Diagnostic procedures on retina, choroid, vitreous, and posterior chamber
14.11 Diagnostic aspiration of vitreous
14.19 Other diagnostic procedures on retina, choroid, vitreous, and posterior chamber
14.2 Destruction of lesion of retina and choroid
Includes: destruction of chorioretinopathy or isolated chorioretinal lesion
Excludes: that for repair of retina (14.31-14.59)
14.21 Destruction of chorioretinal lesion by diathermy
14.22 Destruction of chorioretinal lesion by cryotherapy
14.23 Destruction of chorioretinal lesion by xenon arc photocoagulation
14.24 Destruction of chorioretinal lesion by laser photocoagulation
14.25 Destruction of chorioretinal lesion by photocoagulation of unspecified type
14.26 Destruction of chorioretinal lesion by radiation therapy
14.27 Destruction of chorioretinal lesion by implantation of radiation source
14.29 Other destruction of chorioretinal lesion
Destruction of lesion of retina and choroid NOS
14.3 Repair of retinal tear
Includes: repair of retinal defect
Excludes: repair of retinal detachment (14.41-14.59)
14.31 Repair of retinal tear by diathermy
14.32 Repair of retinal tear by cryotherapy
14.33 Repair of retinal tear by xenon arc photocoagulation
14.34 Repair of retinal tear by laser photocoagulation
14.35 Repair of retinal tear by photocoagulation of unspecified type
14.39 Other repair of retinal tear
14.4 Repair of retinal detachment with scleral buckling and implant
14.41 Scleral buckling with implant
14.49 Other scleral buckling
Scleral buckling with:
air tamponade
resection of sclera
vitrectomy
14.5 Other repair of retinal detachment
Includes: that with drainage
14.51 Repair of retinal detachment with diathermy
14.52 Repair of retinal detachment with cryotherapy
14.53 Repair of retinal detachment with xenon arc photocoagulation
14.54 Repair of retinal detachment with laser photocoagulation
14.55 Repair of retinal detachment with photocoagulation of unspecified type
14.59 Other
14.6 Removal of surgically implanted material from posterior segment of eye
14.7 Operations on vitreous
14.71 Removal of vitreous, anterior approach
Open sky technique
Removal of vitreous, anterior approach (with replacement)
14.72 Other removal of vitreous
Aspiration of vitreous by posterior sclerotomy
14.73 Mechanical vitrectomy by anterior approach
14.74 Other mechanical vitrectomy
Posterior approach
14.75 Injection of vitreous substitute
Excludes: that associated with removal (14.71-14.72)
14.79 Other operations on vitreous
14.9 Other operations on retina, choroid, and posterior chamber
15 Operations on extraocular muscles
15.0 Diagnostic procedures on extraocular muscles or tendons
15.01 Biopsy of extraocular muscle or tendon
15.09 Other diagnostic procedures on extraocular muscles and tendons
15.1 Operations on one extraocular muscle involving temporary detachment from globe
15.11 Recession of one extraocular muscle
15.12 Advancement of one extraocular muscle
15.13 Resection of one extraocular muscle
15.19 Other operations on one extraocular muscle involving temporary detachment from globe
Excludes: transposition of muscle (15.5)
15.2 Other operations on one extraocular muscle
15.21 Lengthening procedure on one extraocular muscle
15.22 Shortening procedure on one extraocular muscle
15.29 Other
15.3 Operations on two or more extraocular muscles involving temporary detachment from globe, one or both eyes
15.4 Other operations on two or more extraocular muscles, one or both eyes
15.5 Transposition of extraocular muscles
Excludes: that for correction of ptosis (08.31-08.36)
15.6 Revision of extraocular muscle surgery
15.7 Repair of injury of extraocular muscle
Freeing of entrapped extraocular muscle
Lysis of adhesions of extraocular muscle
Repair of laceration of extraocular muscle, tendon, or Tenon's capsule
15.9 Other operations on extraocular muscles and tendons
16 Operations on orbit and eyeball
Excludes: reduction of fracture of orbit (76.78-76.79)
16.0 Orbitotomy
16.01 Orbitotomy with bone flap
Orbitotomy with lateral approach
16.02 Orbitotomy with insertion of orbital implant
Excludes: that with bone flap (16.01)
16.09 Other orbitotomy
16.1 Removal of penetrating foreign body from eye, not otherwise specified
Excludes: removal of nonpenetrating foreign body (98.21)
16.2 Diagnostic procedures on orbit and eyeball
16.21 Ophthalmoscopy
16.22 Diagnostic aspiration of orbit
16.23 Biopsy of eyeball and orbit
16.29 Other diagnostic procedures on orbit and eyeball
Excludes: examination of form and structure of eye (95.11-95.16)
general and subjective eye examination (95.01-95.09)
microscopic examination of specimen from eye (90.21-90.29)
objective functional tests of eye (95.21-95.26)
ocular thermography (88.82)
tonometry (89.11)
x-ray of orbit (87.14, 87.16)
16.3 Evisceration of eyeball
16.31 Removal of ocular contents with synchronous implant into scleral shell
16.39 Other evisceration of eyeball
16.4 Enucleation of eyeball
16.41 Enucleation of eyeball with synchronous implant into Tenon's capsule with attachment of muscles
Integrated implant of eyeball
16.42 Enucleation of eyeball with other synchronous implant
16.49 Other enucleation of eyeball
Removal of eyeball NOS
16.5 Exenteration of orbital contents
16.51 Exenteration of orbit with removal of adjacent structures
Radical orbitomaxillectomy
16.52 Exenteration of orbit with therapeutic removal of orbital bone
16.59 Other exenteration of orbit
Evisceration of orbit NOS
Exenteration of orbit with temporalis muscle transplant
16.6 Secondary procedures after removal of eyeball
Excludes: that with synchronous:
enucleation of eyeball (16.41-16.42)
evisceration of eyeball (16.31)
16.61 Secondary insertion of ocular implant
16.62 Revision and reinsertion of ocular implant
16.63 Revision of enucleation socket with graft
16.64 Other revision of enucleation socket
16.65 Secondary graft to exenteration cavity
16.66 Other revision of exenteration cavity
16.69 Other secondary procedures after removal of eyeball
16.7 Removal of ocular or orbital implant
16.71 Removal of ocular implant
16.72 Removal of orbital implant
16.8 Repair of injury of eyeball and orbit
16.81 Repair of wound of orbit
Excludes: reduction of orbital fracture (76.78-76.79)
repair of extraocular muscles (15.7)
16.82 Repair of rupture of eyeball
Repair of multiple structures of eye
Excludes: repair of laceration of:
cornea (11.51-11.59)
sclera (12.81)
16.89 Other repair of injury of eyeball or orbit
16.9 Other operations on orbit and eyeball
Excludes: irrigation of eye (96.51)
prescription and fitting of low vision aids (95.31-95.33)
removal of:
eye prosthesis NEC (97.31)
nonpenetrating foreign body from eye without incision (98.21)
16.91 Retrobulbar injection of therapeutic agent
Excludes: injection of radiographic contrast material (87.14)
opticociliary injection (12.79)
16.92 Excision of lesion of orbit
Excludes: biopsy of orbit (16.23)
16.93 Excision of lesion of eye, unspecified structure
Excludes: biopsy of eye NOS (16.23)
16.98 Other operations on orbit
16.99 Other operations on eyeball
3A. OTHER MISCELLANEOUS DIAGNOSTIC AND THERAPEUTIC PROCEDURES (17)
17 Other miscellaneous procedures
17.1 Laparoscopic unilateral repair of inguinal hernia
Excludes: other and open unilateral repair of hernia (53.00 - 53.05)
17.11 Laparoscopic repair of direct inguinal hernia with graft or prosthesis
Laparoscopic repair of direct and indirect inguinal hernia with graft or prosthesis
17.12 Laparoscopic repair of indirect inguinal hernia with graft or prosthesis
17.13 Laparoscopic repair of inguinal hernia with graft or prosthesis, not otherwise specified
17.2 Laparoscopic bilateral repair of inguinal hernia
Excludes: other and open bilateral repair of hernia (53.10 - 53.17)
17.21 Laparoscopic bilateral repair of direct inguinal hernia with graft or prosthesis
17.22 Laparoscopic bilateral repair of indirect inguinal hernia with graft or prosthesis
17.23 Laparoscopic bilateral repair of inguinal hernia, one direct and one indirect, with graft or prosthesis
17.24 Laparoscopic bilateral repair of inguinal hernia with graft or prosthesis, not otherwise specified
17.3 Laparoscopic partial excision of large intestine
Excludes: other and open partial excision of large intestine (45.71-45.79)
17.31 Laparoscopic multiple segmental resection of large intestine
17.32 Laparoscopic cecectomy
17.33 Laparoscopic right hemicolectomy
17.34 Laparoscopic resection of transverse colon
17.35 Laparoscopic left hemicolectomy
17.36 Laparoscopic sigmoidectomy
17.39 Other laparoscopic partial excision of large intestine
17.4 Robotic assisted procedures
Computer assisted robotic surgery
Computer-enhanced robotic surgery
Robotic procedure with computer assistance
Surgeon-controlled robotic surgery
Code first primary procedure
Excludes: computer assisted surgery (00.31-00.35, 00.39)
Note: This category includes use of a computer console with (3-D) imaging, software, camera(s), visualization and instrumentation combined with the use of robotic arms, device(s), or system(s) at the time of the procedure.
17.41 Open robotic assisted procedure
Robotic assistance in open procedure
17.42 Laparoscopic robotic assisted procedure
Robotic assistance in laparoscopic procedure
17.43 Percutaneous robotic assisted procedure
Robotic assistance in percutaneous procedure
17.44 Endoscopic robotic assisted procedure
Robotic assistance in endoscopic procedure
17.45 Thoracoscopic robotic assisted procedure
Robotic assistance in thoracoscopic procedure
17.49 Other and unspecified robotic assisted procedure
Robotic assistance in other and unspecified procedure
Excludes: endoscopic robotic assisted procedure (17.44)
laparoscopic robotic assisted procedure (17.42)
open robotic assisted procedure (17.41)
percutaneous robotic assisted procedure (17.43)
thoracoscopic robotic assisted procedure (17.45)
17.5 Additional cardiovascular procedures
17.51 Implantation of rechargeable cardiac contractility modulation [CCM], total system
Note: Device testing during procedure - omit code
Implantation of CCM system includes formation of pocket, transvenous leads,
including placement of leads, placement of catheter into left ventricle, intraoperative
procedures for evaluation of lead signals, obtaining sensing threshold measurements,
obtaining defibrillator threshold measurements.
Includes: implantation of device with removal of existing device
Code also any concomitant:
coronary bypass (36.10-36.19)
extracorporeal circulation (39.61)
insertion or replacement of automatic cardioverter/defibrillator, total system [AICD] (37.94)
Excludes: implantation of CCM pulse generator only (17.52)
17.52 Implantation or replacement of cardiac contractility modulation [CCM] rechargeable pulse generator only
Note: Device testing during procedure - omit code
Implantation of CCM device with removal of any existing CCM device
Code also any concomitant:
revision of device pocket (37.79)
revision of lead [electrode] (37.75)
17.6 Laser interstitial thermal therapy [LITT] under guidance
Focused laser interstitial thermal therapy [f-LITT] under MRI guidance
MRI-guided LITT
17.61 Laser interstitial thermal therapy [LITT] of lesion or tissue of brain under guidance
Focused laser interstitial thermal therapy [f-LITT] under MRI guidance
MRI-guided LITT of lesion or tissue of brain
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of head under guidance (17.62)
17.62 Laser interstitial thermal therapy [LITT] of lesion or tissue of head and neck under guidance
Focused laser interstitial thermal therapy [f-LITT] under MRI guidance
MRI-guided LITT of lesion or tissue of head and neck
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of brain under guidance (17.61)
17.63 Laser interstitial thermal therapy [LITT] of lesion or tissue of liver under guidance
Focused laser interstitial thermal therapy [f-LITT] under MRI guidance
MRI-guided LITT of lesion or tissue of liver
17.69 Laser interstitial thermal therapy (LITT) of lesion or tissue of other and unspecified site under guidance
Focused laser interstitial thermal therapy [f-LITT] under MRI guidance
MRI-guided LITT of lesion or tissue of breast
MRI-guided LITT of lesion or tissue of lung
MRI-guided LITT of lesion or tissue of prostate
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of brain under guidance (17.61)
laser interstitial thermal therapy [LITT] of lesion or tissue of head and neck under guidance (17.62)
laser interstitial thermal therapy [LITT] of lesion or tissue of liver under guidance (17.63)
17.7 Other diagnostic and therapeutic procedures
17.70 Intravenous infusion of clofarabine
Excludes: injection or infusion of cancer chemotherapeutic substance (99.25)
4. OPERATIONS ON THE EAR (18-20)
18 Operations on external ear
Includes: operations on:
external auditory canal
skin and cartilage of:
auricle
meatus
18.0 Incision of external ear
Excludes: removal of intraluminal foreign body (98.11)
18.01 Piercing of ear lobe
Piercing of pinna
18.02 Incision of external auditory canal
18.09 Other incision of external ear
18.1 Diagnostic procedures on external ear
18.11 Otoscopy
18.12 Biopsy of external ear
18.19 Other diagnostic procedures on external ear
Excludes: microscopic examination of specimen from ear (90.31-90.39)
18.2 Excision or destruction of lesion of external ear
18.21 Excision of preauricular sinus
Radical excision of preauricular sinus or cyst
Excludes: excision of preauricular remnant [appendage] (18.29)
18.29 Excision or destruction of other lesion of external ear
Cauterization of external ear
Coagulation of external ear
Cryosurgery of external ear
Curettage of external ear
Electrocoagulation of external ear
Enucleation of external ear
Excision of:
exostosis of external auditory canal
preauricular remnant [appendage]
Partial excision of ear
Excludes: biopsy of external ear (18.12)
radical excision of lesion (18.31)
removal of cerumen (96.52)
18.3 Other excision of external ear
Excludes: biopsy of external ear (18.12)
18.31 Radical excision of lesion of external ear
Excludes: radical excision of preauricular sinus (18.21)
18.39 Other
Amputation of external ear
Excludes: excision of lesion (18.21-18.29, 18.31)
18.4 Suture of laceration of external ear
18.5 Surgical correction of prominent ear
Ear:
pinning
setback
18.6 Reconstruction of external auditory canal
Canaloplasty of external auditory meatus
Construction [reconstruction] of external meatus of ear:
osseous portion
skin-lined portion (with skin graft)
18.7 Other plastic repair of external ear
18.71 Construction of auricle of ear
Prosthetic appliance for absent ear
Reconstruction:
auricle
ear
18.72 Reattachment of amputated ear
18.79 Other plastic repair of external ear
Otoplasty NOS
Postauricular skin graft
Repair of lop ear
18.9 Other operations on external ear
Excludes: irrigation of ear (96.52)
packing of external auditory canal (96.11)
removal of:
cerumen (96.52)
foreign body (without incision) (98.11)
19 Reconstructive operations on middle ear
19.0 Stapes mobilization
Division, otosclerotic:
material
process
Remobilization of stapes
Stapediolysis
Transcrural stapes mobilization
Excludes: that with synchronous stapedectomy (19.11-19.19)
19.1 Stapedectomy
Excludes: revision of previous stapedectomy (19.21-19.29)
stapes mobilization only (19.0)
19.11 Stapedectomy with incus replacement
Stapedectomy with incus:
homograft
prosthesis
19.19 Other stapedectomy
19.2 Revision of stapedectomy
19.21 Revision of stapedectomy with incus replacement
19.29 Other revision of stapedectomy
19.3 Other operations on ossicular chain
Incudectomy NOS
Ossiculectomy NOS
Reconstruction of ossicles, second stage
19.4 Myringoplasty
Epitympanic, type I
Myringoplasty by:
cauterization
graft
Tympanoplasty (type I)
19.5 Other tympanoplasty
19.52 Type II tympanoplasty
Closure of perforation with graft against incus or malleus
19.53 Type III tympanoplasty
Graft placed in contact with mobile and intact stapes
19.54 Type IV tympanoplasty
Mobile footplate left exposed with air pocket between round window and graft
19.55 Type V tympanoplasty
Fenestra in horizontal semicircular canal covered by graft
19.6 Revision of tympanoplasty
19.9 Other repair of middle ear
Closure of mastoid fistula
Mastoid myoplasty
Obliteration of tympanomastoid cavity
20 Other operations on middle and inner ear
20.0 Myringotomy
20.01 Myringotomy with insertion of tube
Myringostomy
20.09 Other myringotomy
Aspiration of middle ear NOS
20.1 Removal of tympanostomy tube
20.2 Incision of mastoid and middle ear
20.21 Incision of mastoid
20.22 Incision of petrous pyramid air cells
20.23 Incision of middle ear
Atticotomy
Division of tympanum
Lysis of adhesions of middle ear
Excludes: division of otosclerotic process (19.0)
stapediolysis (19.0)
that with stapedectomy (19.11-19.19)
20.3 Diagnostic procedures on middle and inner ear
20.31 Electrocochleography
20.32 Biopsy of middle and inner ear
20.39 Other diagnostic procedures on middle and inner ear
Excludes: auditory and vestibular function tests (89.13, 95.41-95.49)
microscopic examination of specimen from ear (90.31-90.39)
20.4 Mastoidectomy
Code also any:
skin graft (18.79)
tympanoplasty (19.4-19.55)
Excludes: that with implantation of cochlear prosthetic device (20.96-20.98)
20.41 Simple mastoidectomy
20.42 Radical mastoidectomy
20.49 Other mastoidectomy
Atticoantrostomy
Mastoidectomy:
NOS
modified radical
20.5 Other excision of middle ear
Excludes: that with synchronous mastoidectomy (20.41-20.49)
20.51 Excision of lesion of middle ear
Excludes: biopsy of middle ear (20.32)
20.59 Other
Apicectomy of petrous pyramid
Tympanectomy
20.6 Fenestration of inner ear
20.61 Fenestration of inner ear (initial)
Fenestration of:
labyrinth with graft (skin) (vein)
semicircular canals with graft (skin) (vein)
vestibule with graft (skin) (vein)
Excludes: that with tympanoplasty, type V (19.55)
20.62 Revision of fenestration of inner ear
20.7 Incision, excision, and destruction of inner ear
20.71 Endolymphatic shunt
20.72 Injection into inner ear
Destruction by injection (alcohol):
inner ear
semicircular canals
vestibule
20.79 Other incision, excision, and destruction of inner ear
Decompression of labyrinth
Drainage of inner ear
Fistulization:
endolymphatic sac
labyrinth
Incision of endolymphatic sac
Labyrinthectomy (transtympanic)
Opening of bony labyrinth
Perilymphatic tap
Excludes: biopsy of inner ear (20.32)
20.8 Operations on Eustachian tube
Catheterization of Eustachian tube
Inflation of Eustachian tube
Injection (Teflon paste) of Eustachian tube
Insufflation (boric acid-salicylic acid) Intubation of Eustachian tube
Politzerization of Eustachian tube
20.9 Other operations on inner and middle ear
20.91 Tympanosympathectomy
20.92 Revision of mastoidectomy
20.93 Repair of oval and round windows
Closure of fistula:
oval window
perilymph
round window
20.94 Injection of tympanum
20.95 Implantation of electromagnetic hearing device
Bone conduction hearing device
Excludes: cochlear prosthetic device (20.96-20.98)
20.96 Implantation or replacement of cochlear prosthetic device, not otherwise specified
Implantation of receiver (within skull) and insertion of electrode(s) in the cochlea
Includes: mastoidectomy
Excludes: electromagnetic hearing device (20.95)
20.97 Implantation or replacement of cochlear prosthetic device, single channel
Implantation of receiver (within skull) and insertion of electrode in the cochlea
Includes: mastoidectomy
Excludes: electromagnetic hearing device (20.95)
20.98 Implantation or replacement of cochlear prosthetic device, multiple channel
Implantation of receiver (within skull) and insertion of electrodes in the cochlea
Includes: mastoidectomy
Excludes: electromagnetic hearing device (20.95)
20.99 Other operations on middle and inner ear
Attachment of percutaneous abutment (screw) for prosthetic device
Repair or removal of cochlear prosthetic device (receiver) (electrode)
Excludes: adjustment (external components) of cochlear prosthetic device (95.49)
fitting of hearing aid (95.48)
5. OPERATIONS ON THE NOSE, MOUTH, AND PHARYNX (21-29)
21 Operations on nose
Includes: operations on:
bone of nose
skin of nose
21.0 Control of epistaxis
21.00 Control of epistaxis, not otherwise specified
21.01 Control of epistaxis by anterior nasal packing
21.02 Control of epistaxis by posterior (and anterior) packing
21.03 Control of epistaxis by cauterization (and packing)
21.04 Control of epistaxis by ligation of ethmoidal arteries
21.05 Control of epistaxis by (transantral) ligation of the maxillary artery
21.06 Control of epistaxis by ligation of the external carotid artery
21.07 Control of epistaxis by excision of nasal mucosa and skin grafting of septum and lateral nasal wall
21.09 Control of epistaxis by other means
21.1 Incision of nose
Chondrotomy
Incision of skin of nose
Nasal septotomy
21.2 Diagnostic procedures on nose
21.21 Rhinoscopy
21.22 Biopsy of nose
21.29 Other diagnostic procedures on nose
Excludes: microscopic examination of specimen from nose (90.31-90.39)
nasal:
function study (89.12)
x-ray (87.16)
rhinomanometry (89.12)
21.3 Local excision or destruction of lesion of nose
Excludes: biopsy of nose (21.22)
nasal fistulectomy (21.82)
21.30 Excision or destruction of lesion of nose, not otherwise specified
21.31 Local excision or destruction of intranasal lesion
Nasal polypectomy
21.32 Local excision or destruction of other lesion of nose
21.4 Resection of nose
Amputation of nose
21.5 Submucous resection of nasal septum
21.6 Turbinectomy
21.61 Turbinectomy by diathermy or cryosurgery
21.62 Fracture of the turbinates
21.69 Other turbinectomy
Excludes: turbinectomy associated with sinusectomy (22.31-22.39, 22.42, 22.60-22.64)
21.7 Reduction of nasal fracture
21.71 Closed reduction of nasal fracture
21.72 Open reduction of nasal fracture
21.8 Repair and plastic operations on the nose
21.81 Suture of laceration of nose
21.82 Closure of nasal fistula
Nasolabial fistulectomy
Nasopharyngeal fistulectomy
Oronasal fistulectomy
21.83 Total nasal reconstruction
Reconstruction of nose with:
arm flap
forehead flap
21.84 Revision rhinoplasty
Rhinoseptoplasty
Twisted nose rhinoplasty
21.85 Augmentation rhinoplasty
Augmentation rhinoplasty with:
graft
synthetic implant
21.86 Limited rhinoplasty
Plastic repair of nasolabial flaps
Tip rhinoplasty
21.87 Other rhinoplasty
Rhinoplasty NOS
21.88 Other septoplasty
Crushing of nasal septum
Repair of septal perforation
Excludes: septoplasty associated with submucous resection of septum (21.5)
21.89 Other repair and plastic operations on nose
Reattachment of amputated nose
21.9 Other operations on nose
21.91 Lysis of adhesions of nose
Posterior nasal scrub
21.99 Other
Excludes: dilation of frontonasal duct (96.21)
irrigation of nasal passages (96.53)
removal of:
intraluminal foreign body without incision (98.12)
nasal packing (97.32)
replacement of nasal packing (97.21)
22 Operations on nasal sinuses
22.0 Aspiration and lavage of nasal sinus
22.00 Aspiration and lavage of nasal sinus, not otherwise specified
22.01 Puncture of nasal sinus for aspiration or lavage
22.02 Aspiration or lavage of nasal sinus through natural ostium
22.1 Diagnostic procedures on nasal sinus
22.11 Closed [endoscopic] [needle] biopsy of nasal sinus
22.12 Open biopsy of nasal sinus
22.19 Other diagnostic procedures on nasal sinuses
Endoscopy without biopsy
Excludes: transillumination of sinus (89.35)
x-ray of sinus (87.15-87.16)
22.2 Intranasal antrotomy
Excludes: antrotomy with external approach (22.31-22.39)
22.3 External maxillary antrotomy
22.31 Radical maxillary antrotomy
Removal of lining membrane of maxillary sinus using Caldwell-Luc approach
22.39 Other external maxillary antrotomy
Exploration of maxillary antrum with Caldwell-Luc approach
22.4 Frontal sinusotomy and sinusectomy
22.41 Frontal sinusotomy
22.42 Frontal sinusectomy
Excision of lesion of frontal sinus
Obliteration of frontal sinus (with fat)
Excludes: biopsy of nasal sinus (22.11-22.12)
22.5 Other nasal sinusotomy
22.50 Sinusotomy, not otherwise specified
22.51 Ethmoidotomy
22.52 Sphenoidotomy
22.53 Incision of multiple nasal sinuses
22.6 Other nasal sinusectomy
Includes: that with incidental turbinectomy
Excludes: biopsy of nasal sinus (22.11-22.12)
22.60 Sinusectomy, not otherwise specified
22.61 Excision of lesion of maxillary sinus with Caldwell-Luc approach
22.62 Excision of lesion of maxillary sinus with other approach
22.63 Ethmoidectomy
22.64 Sphenoidectomy
22.7 Repair of nasal sinus
22.71 Closure of nasal sinus fistula
Repair of oro-antral fistula
22.79 Other repair of nasal sinus
Reconstruction of frontonasal duct
Repair of bone of accessory sinus
22.9 Other operations on nasal sinuses
Exteriorization of maxillary sinus
Fistulization of sinus
Excludes: dilation of frontonasal duct (96.21)
23 Removal and restoration of teeth
23.0 Forceps extraction of tooth
23.01 Extraction of deciduous tooth
23.09 Extraction of other tooth
Extraction of tooth NOS
23.1 Surgical removal of tooth
23.11 Removal of residual root
23.19 Other surgical extraction of tooth
Odontectomy NOS
Removal of impacted tooth
Tooth extraction with elevation of mucoperiosteal flap
23.2 Restoration of tooth by filling
23.3 Restoration of tooth by inlay
23.4 Other dental restoration
23.41 Application of crown
23.42 Insertion of fixed bridge
23.43 Insertion of removable bridge
23.49 Other
23.5 Implantation of tooth
23.6 Prosthetic dental implant
Endosseous dental implant
23.7 Apicoectomy and root canal therapy
23.70 Root canal, not otherwise specified
23.71 Root canal therapy with irrigation
23.72 Root canal therapy with apicoectomy
23.73 Apicoectomy
24 Other operations on teeth, gums, and alveoli
24.0 Incision of gum or alveolar bone
Apical alveolotomy
24.1 Diagnostic procedures on teeth, gums, and alveoli
24.11 Biopsy of gum
24.12 Biopsy of alveolus
24.19 Other diagnostic procedures on teeth, gums, and alveoli
Excludes: dental:
examination (89.31)
x-ray:
full-mouth (87.11)
other (87.12)
microscopic examination of dental specimen (90.81-90.89)
24.2 Gingivoplasty
Gingivoplasty with bone or soft tissue graft
24.3 Other operations on gum
24.31 Excision of lesion or tissue of gum
Excludes: biopsy of gum (24.11)
excision of odontogenic lesion (24.4)
24.32 Suture of laceration of gum
24.39 Other
24.4 Excision of dental lesion of jaw
Excision of odontogenic lesion
24.5 Alveoloplasty
Alveolectomy (interradicular) (intraseptal) (radical) (simple) (with graft or implant)
Excludes: biopsy of alveolus (24.12)
en bloc resection of alveolar process and palate (27.32)
24.6 Exposure of tooth
24.7 Application of orthodontic appliance
Application, insertion, or fitting of:
arch bars
orthodontic obturator
orthodontic wiring
periodontal splint
Excludes: nonorthodontic dental wiring (93.55)
24.8 Other orthodontic operation
Closure of diastema (alveolar) (dental)
Occlusal adjustment
Removal of arch bars
Repair of dental arch
Excludes: removal of nonorthodontic wiring (97.33)
24.9 Other dental operations
24.91 Extension or deepening of buccolabial or lingual sulcus
24.99 Other
Excludes: dental:
debridement (96.54)
examination (89.31)
prophylaxis (96.54)
scaling and polishing (96.54)
wiring (93.55)
fitting of dental appliance [denture] (99.97)
microscopic examination of dental specimen (90.81-90.89)
removal of dental:
packing (97.34)
prosthesis (97.35)
wiring (97.33)
replacement of dental packing (97.22)
25 Operations on tongue
25.0 Diagnostic procedures on tongue
25.01 Closed [needle] biopsy of tongue
25.02 Open biopsy of tongue
Wedge biopsy
25.09 Other diagnostic procedures on tongue
25.1 Excision or destruction of lesion or tissue of tongue
Excludes: biopsy of tongue (25.01-25.02)
frenumectomy:
labial (27.41)
lingual (25.92)
25.2 Partial glossectomy
25.3 Complete glossectomy
Glossectomy NOS
Code also any neck dissection (40.40-40.42)
25.4 Radical glossectomy
Code also any:
neck dissection (40.40-40.42)
tracheostomy (31.1-31.29)
25.5 Repair of tongue and glossoplasty
25.51 Suture of laceration of tongue
25.59 Other repair and plastic operations on tongue
Fascial sling of tongue
Fusion of tongue (to lip)
Graft of mucosa or skin to tongue
Excludes: lysis of adhesions of tongue (25.93)
25.9 Other operations on tongue
25.91 Lingual frenotomy
Excludes: labial frenotomy (27.91)
25.92 Lingual frenectomy
Excludes: labial frenectomy (27.41)
25.93 Lysis of adhesions of tongue
25.94 Other glossotomy
25.99 Other
26 Operations on salivary glands and ducts
Includes: operations on:
lesser salivary gland and duct
parotid gland and duct
sublingual gland and duct
submaxillary gland and duct
Code also any neck dissection (40.40-40.42)
26.0 Incision of salivary gland or duct
26.1 Diagnostic procedures on salivary glands and ducts
26.11 Closed [needle] biopsy of salivary gland or duct
26.12 Open biopsy of salivary gland or duct
26.19 Other diagnostic procedures on salivary glands and ducts
Excludes: x-ray of salivary gland (87.09)
26.2 Excision of lesion of salivary gland
26.21 Marsupialization of salivary gland cyst
26.29 Other excision of salivary gland lesion
Excludes: biopsy of salivary gland (26.11-26.12)
salivary fistulectomy (26.42)
26.3 Sialoadenectomy
26.30 Sialoadenectomy, not otherwise specified
26.31 Partial sialoadenectomy
26.32 Complete sialoadenectomy
En bloc excision of salivary gland lesion
Radical sialoadenectomy
26.4 Repair of salivary gland or duct
26.41 Suture of laceration of salivary gland
26.42 Closure of salivary fistula
26.49 Other repair and plastic operations on salivary gland or duct
Fistulization of salivary gland
Plastic repair of salivary gland or duct NOS
Transplantation of salivary duct opening
26.9 Other operations on salivary gland or duct
26.91 Probing of salivary duct
26.99 Other
27 Other operations on mouth and face
Includes: operations on:
lips
palate
soft tissue of face and mouth, except tongue and gingiva
Excludes: operations on:
gingiva (24.0-24.99)
tongue (25.01-25.99)
27.0 Drainage of face and floor of mouth
Drainage of:
facial region (abscess)
fascial compartment of face
Ludwig's angina
Excludes: drainage of thyroglossal tract (06.09)
27.1 Incision of palate
27.2 Diagnostic procedures on oral cavity
27.21 Biopsy of bony palate
27.22 Biopsy of uvula and soft palate
27.23 Biopsy of lip
27.24 Biopsy of mouth, unspecified structure
27.29 Other diagnostic procedures on oral cavity
Excludes: soft tissue x-ray (87.09)
27.3 Excision of lesion or tissue of bony palate
27.31 Local excision or destruction of lesion or tissue of bony palate
Local excision or destruction of palate by:
cautery
chemotherapy
cryotherapy
Excludes: biopsy of bony palate (27.21)
27.32 Wide excision or destruction of lesion or tissue of bony palate
En bloc resection of alveolar process and palate
27.4 Excision of other parts of mouth
27.41 Labial frenectomy
Excludes: division of labial frenum (27.91)
27.42 Wide excision of lesion of lip
27.43 Other excision of lesion or tissue of lip
27.49 Other excision of mouth
Excludes: biopsy of mouth NOS (27.24)
excision of lesion of:
palate (27.31-27.32)
tongue (25.1)
uvula (27.72)
fistulectomy of mouth (27.53)
frenectomy of:
lip (27.41)
tongue (25.92)
27.5 Plastic repair of lip and mouth
Excludes: palatoplasty (27.61-27.69)
27.51 Suture of laceration of lip
27.52 Suture of laceration of other part of mouth
27.53 Closure of fistula of mouth
Excludes: fistulectomy:
nasolabial (21.82)
oro-antral (22.71)
oronasal (21.82)
27.54 Repair of cleft lip
27.55 Full-thickness skin graft to lip and mouth
27.56 Other skin graft to lip and mouth
27.57 Attachment of pedicle or flap graft to lip and mouth
27.59 Other plastic repair of mouth
27.6 Palatoplasty
27.61 Suture of laceration of palate
27.62 Correction of cleft palate
Correction of cleft palate by push-back operation
Excludes: revision of cleft palate repair (27.63)
27.63 Revision of cleft palate repair
Secondary:
attachment of pharyngeal flap
lengthening of palate
27.64 Insertion of palatal implant
27.69 Other plastic repair of palate
Code also any insertion of palatal implant (27.64)
Excludes: fistulectomy of mouth (27.53)
27.7 Operations on uvula
27.71 Incision of uvula
27.72 Excision of uvula
Excludes: biopsy of uvula (27.22)
27.73 Repair of uvula
Excludes: that with synchronous cleft palate repair (27.62)
uranostaphylorrhaphy (27.62)
27.79 Other operations on uvula
27.9 Other operations on mouth and face
27.91 Labial frenotomy
Division of labial frenum
Excludes: lingual frenotomy (25.91)
27.92 Incision of mouth, unspecified structure
Excludes: incision of:
gum (24.0)
palate (27.1)
salivary gland or duct (26.0)
tongue (25.94)
uvula (27.71)
27.99 Other operations on oral cavity
Graft of buccal sulcus
Excludes: removal of:
intraluminal foreign body (98.01)
penetrating foreign body from mouth without incision (98.22)
28 Operations on tonsils and adenoids
28.0 Incision and drainage of tonsil and peritonsillar structures
Drainage (oral) (transcervical) of:
parapharyngeal abscess
peritonsillar abscess
retropharyngeal abscess
tonsillar abscess
28.1 Diagnostic procedures on tonsils and adenoids
28.11 Biopsy of tonsils and adenoids
28.19 Other diagnostic procedures on tonsils and adenoids
Excludes: soft tissue x-ray (87.09)
28.2 Tonsillectomy without adenoidectomy
28.3 Tonsillectomy with adenoidectomy
28.4 Excision of tonsil tag
28.5 Excision of lingual tonsil
28.6 Adenoidectomy without tonsillectomy
Excision of adenoid tag
28.7 Control of hemorrhage after tonsillectomy and adenoidectomy
28.9 Other operations on tonsils and adenoids
28.91 Removal of foreign body from tonsil and adenoid by incision
Excludes: that without incision (98.13)
28.92 Excision of lesion of tonsil and adenoid
Excludes: biopsy of tonsil and adenoid (28.11)
28.99 Other
29 Operations on pharynx
Includes: operations on:
hypopharynx
nasopharynx
oropharynx
pharyngeal pouch
pyriform sinus
29.0 Pharyngotomy
Drainage of pharyngeal bursa
Excludes: incision and drainage of retropharyngeal abscess (28.0)
removal of foreign body (without incision) (98.13)
29.1 Diagnostic procedures on pharynx
29.11 Pharyngoscopy
29.12 Pharyngeal biopsy
Biopsy of supraglottic mass
29.19 Other diagnostic procedures on pharynx
Excludes: x-ray of nasopharynx:
contrast (87.06)
other (87.09)
29.2 Excision of branchial cleft cyst or vestige
Excludes: branchial cleft fistulectomy (29.52)
29.3 Excision or destruction of lesion or tissue of pharynx
29.31 Cricopharyngeal myotomy
Excludes: that with pharyngeal diverticulectomy (29.32)
29.32 Pharyngeal diverticulectomy
29.33 Pharyngectomy (partial)
Excludes: laryngopharyngectomy (30.3)
29.39 Other excision or destruction of lesion or tissue of pharynx
29.4 Plastic operation on pharynx
Correction of nasopharyngeal atresia
Excludes: pharyngoplasty associated with cleft palate repair (27.62-27.63)
29.5 Other repair of pharynx
29.51 Suture of laceration of pharynx
29.52 Closure of branchial cleft fistula
29.53 Closure of other fistula of pharynx
Pharyngoesophageal fistulectomy
29.54 Lysis of pharyngeal adhesions
29.59 Other
29.9 Other operations on pharynx
29.91 Dilation of pharynx
Dilation of nasopharynx
29.92 Division of glossopharyngeal nerve
29.99 Other
Excludes: insertion of radium into pharynx and nasopharynx (92.27)
removal of intraluminal foreign body (98.13)
6. OPERATIONS ON THE RESPIRATORY SYSTEM (30-34)
30 Excision of larynx
30.0 Excision or destruction of lesion or tissue of larynx
30.01 Marsupialization of laryngeal cyst
30.09 Other excision or destruction of lesion or tissue of larynx
Stripping of vocal cords
Excludes: biopsy of larynx (31.43)
laryngeal fistulectomy (31.62)
laryngotracheal fistulectomy (31.62)
30.1 Hemilaryngectomy
30.2 Other partial laryngectomy
30.21 Epiglottidectomy
30.22 Vocal cordectomy
Excision of vocal cords
30.29 Other partial laryngectomy
Excision of laryngeal cartilage
30.3 Complete laryngectomy
Block dissection of larynx (with thyroidectomy) (with synchronous tracheostomy)
Laryngopharyngectomy
Excludes: that with radical neck dissection (30.4)
30.4 Radical laryngectomy
Complete [total] laryngectomy with radical neck dissection (with thyroidectomy) (with synchronous tracheostomy)
31 Other operations on larynx and trachea
31.0 Injection of larynx
Injection of inert material into larynx or vocal cords
31.1 Temporary tracheostomy
Temporary percutaneous dilatational tracheostomy [PDT]
Tracheotomy for assistance in breathing
Code also any synchronous bronchoscopy, if performed (33.21 - 33.24, 33.27)
31.2 Permanent tracheostomy
31.21 Mediastinal tracheostomy
31.29 Other permanent tracheostomy
Permanent percutaneous dilatational tracheostomy [PDT]
Code also any synchronous bronchoscopy, if performed (33.21- 33.24, 33.27)
Excludes: that with laryngectomy (30.3-30.4)
31.3 Other incision of larynx or trachea
Excludes: that for assistance in breathing (31.1-31.29)
31.4 Diagnostic procedures on larynx and trachea
31.41 Tracheoscopy through artificial stoma
Excludes: that with biopsy (31.43-31.44)
31.42 Laryngoscopy and other tracheoscopy
Excludes: that with biopsy (31.43-31.44)
31.43 Closed [endoscopic] biopsy of larynx
31.44 Closed [endoscopic] biopsy of trachea
31.45 Open biopsy of larynx or trachea
31.48 Other diagnostic procedures on larynx
Excludes: contrast laryngogram (87.07)
microscopic examination of specimen from larynx (90.31-90.39)
soft tissue x-ray of larynx NEC (87.09)
31.49 Other diagnostic procedures on trachea
Excludes: microscopic examination of specimen from trachea (90.41-90.49)
x-ray of trachea (87.49)
31.5 Local excision or destruction of lesion or tissue of trachea
Excludes: biopsy of trachea (31.44-31.45)
laryngotracheal fistulectomy (31.62)
tracheoesophageal fistulectomy (31.73)
31.6 Repair of larynx
31.61 Suture of laceration of larynx
31.62 Closure of fistula of larynx
Laryngotracheal fistulectomy
Take-down of laryngostomy
31.63 Revision of laryngostomy
31.64 Repair of laryngeal fracture
31.69 Other repair of larynx
Arytenoidopexy
Graft of larynx
Transposition of vocal cords
Excludes: construction of artificial larynx (31.75)
31.7 Repair and plastic operations on trachea
31.71 Suture of laceration of trachea
31.72 Closure of external fistula of trachea
Closure of tracheotomy
31.73 Closure of other fistula of trachea
Tracheoesophageal fistulectomy
Excludes: laryngotracheal fistulectomy (31.62)
31.74 Revision of tracheostomy
31.75 Reconstruction of trachea and construction of artificial larynx
Tracheoplasty with artificial larynx
31.79 Other repair and plastic operations on trachea
31.9 Other operations on larynx and trachea
31.91 Division of laryngeal nerve
31.92 Lysis of adhesions of trachea or larynx
31.93 Replacement of laryngeal or tracheal stent
31.94 Injection of locally-acting therapeutic substance into trachea
31.95 Tracheoesophageal fistulization
31.98 Other operations on larynx
Dilation of larynx
Division of congenital web of larynx
Removal of keel or stent of larynx
Excludes: removal of intraluminal foreign body from larynx without incision (98.14)
31.99 Other operations on trachea
Excludes: removal of:
intraluminal foreign body from trachea without incision (98.15)
tracheostomy tube (97.37)
replacement of tracheostomy tube (97.23)
tracheostomy toilette (96.55)
32 Excision of lung and bronchus
Includes: rib resection as operative approach
sternotomy as operative approach
sternum-splitting incision as operative approach
thoracotomy as operative approach
Code also any synchronous bronchoplasty (33.48)
32.0 Local excision or destruction of lesion or tissue of bronchus
Excludes: biopsy of bronchus (33.24-33.25)
bronchial fistulectomy (33.42)
32.01 Endoscopic excision or destruction of lesion or tissue of bronchus
32.09 Other local excision or destruction of lesion or tissue of bronchus
Excludes: that by endoscopic approach (32.01)
32.1 Other excision of bronchus
Resection (wide sleeve) of bronchus
Excludes: radical dissection [excision] of bronchus (32.6)
32.2 Local excision or destruction of lesion or tissue of lung
32.20 Thoracoscopic excision of lesion or tissue of lung
Thoracoscopic wedge resection
32.21 Plication of emphysematous bleb
32.22 Lung volume reduction surgery
32.23 Open ablation of lung lesion or tissue
32.24 Percutaneous ablation of lung lesion or tissue
32.25 Thoracoscopic ablation of lung lesion or tissue
Excludes: thoracoscopic excision of lesion or tissue of lung (32.20)
32.26 Other and unspecified ablation of lung lesion or tissue
32.28 Endoscopic excision or destruction of lesion or tissue of lung
Excludes: ablation of lung lesion or tissue:
open (32.23)
other (32.26)
percutaneous (32.24)
thoracoscopic (32.25)
biopsy of lung (33.26-33.27)
32.29 Other local excision or destruction of lesion or tissue of lung
Resection of lung:
NOS
wedge
Excludes: ablation of lung lesion or tissue:
open (32.23)
other (32.26)
percutaneous (32.24)
thoracoscopic (32.25)
biopsy of lung (33.26-33.27)
laser interstitial thermal therapy [LITT] of lesion or tissue of lung under guidance (17.69)
that by endoscopic approach (32.28)
thoracoscopic excision of lesion or tissue of lung (32.20)
wide excision of lesion of lung (32.3)
32.3 Segmental resection of lung
Partial lobectomy
32.30 Thoracoscopic segmental resection of lung
32.39 Other and unspecified segmental resection of lung
Excludes: thoracoscopic segmental resection of lung (32.30)
32.4 Lobectomy of lung
Lobectomy with segmental resection of adjacent lobes of lung
Excludes: that with radical dissection [excision] of thoracic structures (32.6)
32.41 Thoracoscopic lobectomy of lung
32.49 Other lobectomy of lung
Excludes: thoracoscopic lobectomy of lung (32.41)
32.5 Pneumonectomy
Excision of lung NOS
Pneumonectomy (with mediastinal dissection)
32.50 Thoracoscopic pneumonectomy
32.59 Other and unspecified pneumonectomy
Excludes: thoracoscopic pneumonectomy (32.50)
32.6 Radical dissection of thoracic structures
Block [en bloc] dissection of bronchus, lobe of lung, brachial plexus, intercostal structure, ribs (transverse process), and sympathetic nerves
32.9 Other excision of lung
Excludes: biopsy of lung and bronchus (33.24-33.27)
pulmonary decortication (34.51)
33 Other operations on lung and bronchus
Includes: rib resection as operative approach
sternotomy as operative approach
sternum-splitting incision as operative approach
thoracotomy as operative approach
33.0 Incision of bronchus
33.1 Incision of lung
Excludes: puncture of lung (33.93)
33.2 Diagnostic procedures on lung and bronchus
33.20 Thoracoscopic lung biopsy
Excludes: closed endoscopic biopsy of lung (33.27)
closed [percutaneous] [needle] biopsy of lung (33.26)
open biopsy of lung (33.28)
33.21 Bronchoscopy through artificial stoma
Excludes: that with biopsy (33.24,33.27)
33.22 Fiber-optic bronchoscopy
Excludes: that with biopsy (33.24,33.27)
33.23 Other bronchoscopy
Excludes: that for:
aspiration (96.05)
biopsy (33.24,33.27)
33.24 Closed [endoscopic] biopsy of bronchus
Bronchoscopy (fiberoptic) (rigid) with:
brush biopsy of "lung"
brushing or washing for specimen collection
excision (bite) biopsy
Diagnostic bronchoalveolar lavage (BAL)
Transbronchoscopic needle aspiration [TBNA]
Excludes: closed biopsy of lung, other than brush biopsy of "lung" (33.26,33.27)
whole lung lavage (33.99)
33.25 Open biopsy of bronchus
Excludes: open biopsy of lung (33.28)
33.26 Closed [percutaneous] [needle] biopsy of lung
Fine needle aspiration (FNA) of lung
Transthoracic needle biopsy of lung (TTNB)
Excludes: endoscopic biopsy of lung (33.27)
thoracoscopic lung biopsy (33.20)
33.27 Closed endoscopic biopsy of lung
Fiber-optic (flexible) bronchoscopy with fluoroscopic guidance with biopsy
Transbronchial lung biopsy
Excludes: brush biopsy of "lung" (33.24)
percutaneous biopsy of lung (33.26)
thoracoscopic lung biopsy (33.20)
33.28 Open biopsy of lung
33.29 Other diagnostic procedures on lung and bronchus
Excludes: contrast bronchogram:
endotracheal (87.31)
other (87.32)
endoscopic pulmonary airway flow measurement (33.72)
lung scan (92.15)
magnetic resonance imaging (88.92)
microscopic examination of specimen from bronchus or lung (90.41-90.49)
routine chest x-ray (87.44)
ultrasonography of lung (88.73)
vital capacity determination (89.37)
x-ray of bronchus or lung NOS (87.49)
33.3 Surgical collapse of lung
33.31 Destruction of phrenic nerve for collapse of lung
33.32 Artificial pneumothorax for collapse of lung
Thoracotomy for collapse of lung
33.33 Pneumoperitoneum for collapse of lung
33.34 Thoracoplasty
33.39 Other surgical collapse of lung
Collapse of lung NOS
33.4 Repair and plastic operation on lung and bronchus
33.41 Suture of laceration of bronchus
33.42 Closure of bronchial fistula
Closure of bronchostomy
Fistulectomy:
bronchocutaneous
bronchoesophageal
bronchovisceral
Excludes: closure of fistula:
bronchomediastinal (34.73)
bronchopleural (34.73)
bronchopleuromediastinal (34.73)
33.43 Closure of laceration of lung
33.48 Other repair and plastic operations on bronchus
33.49 Other repair and plastic operations on lung
Excludes: closure of pleural fistula (34.73)
33.5 Lung transplant
Note: To report donor source - see codes 00.91-00.93
Excludes: combined heart-lung transplantation (33.6)
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
33.50 Lung transplantation, not otherwise specified
33.51 Unilateral lung transplantation
33.52 Bilateral lung transplantation
Double-lung transplantation
En bloc transplantation
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
33.6 Combined heart-lung transplantation
Note: To report donor source - see codes 00.91-00.93
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
33.7 Other endoscopic procedures in bronchus or lung
Excludes insertion of tracheobronchial stent (96.05)
33.71 Endoscopic insertion or replacement of bronchial valve(s), single lobe
Endobronchial airflow redirection valve
Intrabronchial airflow redirection valve
Excludes: endoscopic insertion or replacement of bronchial valve(s), multiple lobes (33.73)
33.72 Endoscopic pulmonary airway flow measurement
Assessment of pulmonary airway flow
Code also any diagnostic or therapeutic procedure if performed
33.73 Endoscopic insertion or replacement of bronchial valve(s), multiple lobes
Excludes: endoscopic insertion or replacement of bronchial valve(s), single lobe (33.71)
33.78 Endoscopic removal of bronchial device(s) or substances
33.79 Endoscopic insertion of other bronchial device or substances
Biologic Lung Volume Reduction NOS (BLVR)
33.9 Other operations on lung and bronchus
33.91 Bronchial dilation
33.92 Ligation of bronchus
33.93 Puncture of lung
Excludes: needle biopsy (33.26)
33.98 Other operations on bronchus
Excludes: bronchial lavage (96.56)
removal of intraluminal foreign body from bronchus without incision (98.15)
33.99 Other operations on lung
Whole lung lavage
Excludes: other continuous mechanical ventilation (96.70-96.72)
respiratory therapy (93.90-93.99)
34 Operations on chest wall, pleura, mediastinum, and diaphragm
Excludes: operations on breast (85.0-85.99)
34.0 Incision of chest wall and pleura
Excludes: that as operative approach -- omit code
34.01 Incision of chest wall
Extrapleural drainage
Excludes: incision of pleura (34.09)
34.02 Exploratory thoracotomy
34.03 Reopening of recent thoracotomy site
34.04 Insertion of intercostal catheter for drainage
Chest tube
Closed chest drainage
Revision of intercostal catheter (chest tube) (with lysis of adhesions)
Excludes: thoracoscopic drainage of pleural cavity (34.06)
34.05 Creation of pleuroperitoneal shunt
34.06 Thoracoscopic drainage of pleural cavity
Evacuation of empyema
34.09 Other incision of pleura
Creation of pleural window for drainage
Intercostal stab
Open chest drainage
Excludes: thoracoscopy (34.21)
thoracotomy for collapse of lung (33.32)
34.1 Incision of mediastinum
Code also any biopsy, if performed
Excludes: mediastinoscopy (34.22)
mediastinotomy associated with pneumonectomy (32.5)
34.2 Diagnostic procedures on chest wall, pleura, mediastinum, and diaphragm
34.20 Thoracoscopic pleural biopsy
34.21 Transpleural thoracoscopy
34.22 Mediastinoscopy
Code also any biopsy, if performed
34.23 Biopsy of chest wall
34.24 Other pleural biopsy
Excludes: thoracoscopic pleural biopsy (34.20)
34.25 Closed [percutaneous] [needle] biopsy of mediastinum
34.26 Open mediastinal biopsy
34.27 Biopsy of diaphragm
34.28 Other diagnostic procedures on chest wall, pleura, and diaphragm
Excludes: angiocardiography (88.50-88.58)
aortography (88.42)
arteriography of:
intrathoracic vessels NEC (88.44)
pulmonary arteries (88.43)
microscopic examination of specimen from chest wall, pleura, and diaphragm (90.41-90.49)
phlebography of:
intrathoracic vessels NEC (88.63)
pulmonary veins (88.62)
radiological examinations of thorax:
C.A.T. scan (87.41)
diaphragmatic x-ray (87.49)
intrathoracic lymphangiogram (87.34)
routine chest x-ray (87.44)
sinogram of chest wall (87.38)
soft tissue x-ray of chest wall NEC (87.39)
tomogram of thorax NEC (87.42)
ultrasonography of thorax 88.73)
34.29 Other diagnostic procedures on mediastinum
Excludes: mediastinal:
pneumogram (87.33)
x-ray NEC (87.49)
34.3 Excision or destruction of lesion or tissue of mediastinum
Excludes: biopsy of mediastinum (34.25-34.26)
mediastinal fistulectomy (34.73)
34.4 Excision or destruction of lesion of chest wall
Excision of lesion of chest wall NOS (with excision of ribs)
Excludes: biopsy of chest wall (34.23)
costectomy not incidental to thoracic procedure (77.91)
excision of lesion of:
breast (85.20-85.25)
cartilage (80.89)
skin (86.2-86.3)
fistulectomy (34.73)
34.5 Pleurectomy
34.51 Decortication of lung
Excludes: thoracoscopic decortication of lung (34.52)
34.52 Thoracoscopic decortication of lung
34.59 Other excision of pleura
Excision of pleural lesion
Excludes: biopsy of pleura (34.24)
pleural fistulectomy (34.73)
34.6 Scarification of pleura
Pleurosclerosis
Excludes: injection of sclerosing agent (34.92)
34.7 Repair of chest wall
34.71 Suture of laceration of chest wall
Excludes: suture of skin and subcutaneous tissue alone (86.59)
34.72 Closure of thoracostomy
34.73 Closure of other fistula of thorax
Closure of:
bronchopleural fistula
bronchopleurocutaneous fistula
bronchopleuromediastinal fistula
34.74 Repair of pectus deformity
Repair of:
pectus carinatum (with implant)
pectus excavatum (with implant)
34.79 Other repair of chest wall
Repair of chest wall NOS
34.8 Operations on diaphragm
34.81 Excision of lesion or tissue of diaphragm
Excludes: biopsy of diaphragm (34.27)
34.82 Suture of laceration of diaphragm
34.83 Closure of fistula of diaphragm
Thoracicoabdominal fistulectomy
Thoracicogastric fistulectomy
Thoracicointestinal fistulectomy
34.84 Other repair of diaphragm
Excludes: repair of diaphragmatic hernia (53.7-53.82)
34.85 Implantation of diaphragmatic pacemaker
34.89 Other operations on diaphragm
34.9 Other operations on thorax
34.91 Thoracentesis
34.92 Injection into thoracic cavity
Chemical pleurodesis
Injection of cytotoxic agent or tetracycline
Instillation into thoracic cavity
Requires additional code for any cancer chemotherapeutic substance (99.25)
Excludes: that for collapse of lung (33.32)
34.93 Repair of pleura
34.99 Other
Excludes: removal of:
mediastinal drain (97.42)
sutures (97.43)
thoracotomy tube (97.41)
7. OPERATIONS ON THE CARDIOVASCULAR SYSTEM (35-39)
35 Operations on valves and septa of heart
Includes: sternotomy (median) (transverse) as operative approach
thoracotomy as operative approach
Code also cardiopulmonary bypass [extracorporeal
circulation] [heart-lung machine] (39.61)
35.0 Closed heart valvotomy
Excludes: percutaneous (balloon) valvuloplasty (35.96)
35.00 Closed heart valvotomy, unspecified valve
35.01 Closed heart valvotomy, aortic valve
35.02 Closed heart valvotomy, mitral valve
35.03 Closed heart valvotomy, pulmonary valve
35.04 Closed heart valvotomy, tricuspid valve
35.1 Open heart valvuloplasty without replacement
Includes: open heart valvotomy
Excludes: that associated with repair of:
endocardial cushion defect (35.54, 35.63, 35.73)
valvular defect associated with atrial and ventricular septal defects (35.54, 35.63, 35.73)
percutaneous (balloon) valvuloplasty (35.96)
Code also cardiopulmonary bypass if performed [extracorporeal circulation] [heart-lung machine] (39.61)
35.10 Open heart valvuloplasty without replacement, unspecified valve
35.11 Open heart valvuloplasty of aortic valve without replacement
35.12 Open heart valvuloplasty of mitral valve without replacement
35.13 Open heart valvuloplasty of pulmonary valve without replacement
35.14 Open heart valvuloplasty of tricuspid valve without replacement
35.2 Replacement of heart valve
Includes: excision of heart valve with replacement
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
Excludes: that associated with repair of:
endocardial cushion defect (35.54, 35.63, 35.73)
valvular defect associated with atrial and ventricular septal defects (35.54, 35.63, 35.73)
35.20 Replacement of unspecified heart valve
Repair of unspecified heart valve with tissue graft or prosthetic implant
35.21 Replacement of aortic valve with tissue graft
Repair of aortic valve with tissue graft (autograft) (heterograft) (homograft)
35.22 Other replacement of aortic valve
Repair of aortic valve with replacement:
NOS
prosthetic (partial) (synthetic) (total)
35.23 Replacement of mitral valve with tissue graft
Repair of mitral valve with tissue graft (autograft) (heterograft) (homograft)
35.24 Other replacement of mitral valve
Repair of mitral valve with replacement:
NOS
prosthetic (partial) (synthetic) (total)
35.25 Replacement of pulmonary valve with tissue graft
Repair of pulmonary valve with tissue graft (autograft) (heterograft) (homograft)
35.26 Other replacement of pulmonary valve
Repair of pulmonary valve with replacement:
NOS
prosthetic (partial) (synthetic) (total)
35.27 Replacement of tricuspid valve with tissue graft
Repair of tricuspid valve with tissue graft (autograft) (heterograft) (homograft)
35.28 Other replacement of tricuspid valve
Repair of tricuspid valve with replacement:
NOS
prosthetic (partial) (synthetic) (total)
35.3 Operations on structures adjacent to heart valves
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
35.31 Operations on papillary muscle
Division of papillary muscle
Reattachment of papillary muscle
Repair of papillary muscle
35.32 Operations on chordae tendineae
Division of chordae tendineae
Repair of chordae tendineae
35.33 Annuloplasty
Plication of annulus
35.34 Infundibulectomy
Right ventricular infundibulectomy
35.35 Operations on trabeculae carneae cordis
Division of trabeculae carneae cordis
Excision of trabeculae carneae cordis
Excision of aortic subvalvular ring
35.39 Operations on other structures adjacent to valves of heart
Repair of sinus of Valsalva (aneurysm)
35.4 Production of septal defect in heart
35.41 Enlargement of existing atrial septal defect
Rashkind procedure
Septostomy (atrial) (balloon)
35.42 Creation of septal defect in heart
Blalock-Hanlon operation
35.5 Repair of atrial and ventricular septa with prosthesis
Includes: repair of septa with synthetic implant or patch
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
35.50 Repair of unspecified septal defect of heart with prosthesis
Excludes: that associated with repair of:
endocardial cushion defect (35.54)
septal defect associated with valvular defect (35.54)
35.51 Repair of atrial septal defect with prosthesis, open technique
Atrioseptoplasty with prosthesis
Correction of atrial septal defect with prosthesis
Repair:
foramen ovale (patent)
with prosthesis ostium secundum defect with prosthesis
Excludes: that associated with repair of:
atrial septal defect associated with valvular and ventricular septal defects (35.54)
endocardial cushion defect (35.54)
35.52 Repair of atrial septal defect with prosthesis, closed technique
Insertion of atrial septal umbrella [King-Mills]
35.53 Repair of ventricular septal defect with prosthesis, open technique
Correction of ventricular septal defect with prosthesis
Repair of supracristal defect with prosthesis
Excludes: that associated with repair of:
endocardial cushion defect (35.54)
ventricular defect associated with valvular and atrial septal defects (35.54)
35.54 Repair of endocardial cushion defect with prosthesis
Repair:
atrioventricular canal with prosthesis (grafted to septa)
ostium primum defect with prosthesis (grafted to septa)
valvular defect associated with atrial and ventricular septal defects with prosthesis (grafted to septa)
Excludes: repair of isolated:
atrial septal defect (35.51-35.52)
valvular defect (35.20, 35.22, 35.24, 35.26, 35.28)
ventricular septal defect (35.53)
35.55 Repair of ventricular septal defect with prosthesis, closed technique
35.6 Repair of atrial and ventricular septa with tissue graft
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
35.60 Repair of unspecified septal defect of heart with tissue graft
Excludes: that associated with repair of:
endocardial cushion defect (35.63)
septal defect associated withvalvular defect (35.63)
35.61 Repair of atrial septal defect with tissue graft
Atrioseptoplasty with tissue graft
Correction of atrial septal defect with tissue graft
Repair:
foramen ovale (patent) with tissue graft
ostium secundum defect with tissue graft
Excludes: that associated with repair of:
atrial septal defect associated with valvular and ventricular septal defects (35.63)
endocardial cushion defect (35.63)
35.62 Repair of ventricular septal defect with tissue graft
Correction of ventricular septal defect with tissue graft
Repair of supracristal defect with tissue graft
Excludes: that associated with repair of:
endocardial cushion defect(35.63)
ventricular defect associate with valvular and atrial septal defects (35.63)
35.63 Repair of endocardial cushion defect with tissue graft
Repair of:
atrioventricular canal with tissue graft
ostium primum defect with tissue graft
valvular defect associated with atrial and ventricular septal defects with tissue graft
Excludes: repair of isolated:
atrial septal defect (35.61)
valvular defect (35.20-35.21, 35.23, 35.25, 35.27)
ventricular septal defect (35.62)
35.7 Other and unspecified repair of atrial and ventricular septa
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
35.70 Other and unspecified repair of unspecified septal defect of heart
Repair of septal defect NOS
Excludes: that associated with repair of:
endocardial cushion defect (35.73)
septal defect associated wit valvular defect (35.73)
35.71 Other and unspecified repair of atrial septal defect
Repair NOS:
atrial septum
foramen ovale (patent)
ostium secundum defect
Excludes: that associated with repair of:
atrial septal defect associated with valvular ventricular septal defects (35.73)
endocardial cushion defect (35.73)
35.72 Other and unspecified repair of ventricular septal defect
Repair NOS:
supracristal defect
ventricular septum
Excludes: that associated with repair of:
endocardial cushion defect (35.73)
ventricular septal defect associated with valvular and atrial septal defects (35.73)
35.73 Other and unspecified repair of endocardial cushion defect
Repair NOS:
atrioventricular canal
ostium primum defect
valvular defect associated with atrial and ventricular septal defects
Excludes: repair of isolated:
atrial septal defect (35.71)
valvular defect (35.20, 35.22, 35.24, 35.26, 35.28)
ventricular septal defect (35.72)
35.8 Total repair of certain congenital cardiac anomalies
Note: For partial repair of defect [e.g. repair of atrial septal defect in tetralogy of Fallot] -- code to specific procedure
35.81 Total repair of tetralogy of Fallot
One-stage total correction of tetralogy of Fallot with or without:
commissurotomy of pulmonary valve
infundibulectomy
outflow tract prosthesis
patch graft of outflow tract
prosthetic tube for pulmonary artery
repair of ventricular septal defect (with prosthesis)
take-down of previous systemic-pulmonary artery anastomosis
35.82 Total repair of total anomalous pulmonary venous connection
One-stage total correction of total anomalous pulmonary venous connection with or without:
anastomosis between (horizontal) common pulmonary trunk and posterior wall of left atrium (side-to-side)
enlargement of foramen ovale
incision [excision] of common wall between posterior left atrium and coronary sinus and roofing of resultant defect with patch graft (synthetic)
ligation of venous connection (descending anomalous vein) (to left innominate vein) (to superior vena cava)
repair of atrial septal defect (with prosthesis)
35.83 Total repair of truncus arteriosus
One-stage total correction of truncus arteriosus with or without:
construction (with aortic homograft) (with prosthesis) of a pulmonary artery placed from right ventricle to arteries supplying the lung
ligation of connections between aorta and pulmonary artery
repair of ventricular septal defect (with prosthesis)
35.84 Total correction of transposition of great vessels, not elsewhere classified
Arterial switch operation [Jatene]
Total correction of transposition of great arteries at the arterial level by switching the great arteries, including the left or both coronary arteries, implanted in the wall of the pulmonary artery
Excludes: baffle operation [Mustard] [Senning] (35.91)
creation of shunt between right ventricle and pulmonary artery [Rastelli] (35.92)
35.9 Other operations on valves and septa of heart
Code also cardiopulmonary bypass, if performed [extracorporeal circulation] [heart-lung machine] (39.61)
35.91 Interatrial transposition of venous return
Baffle:
atrial
interatrial
Mustard's operation
Resection of atrial septum and insertion of patch to direct systemic venous return to tricuspid valve and pulmonary venousreturn to mitral valve
35.92 Creation of conduit between right ventricle and pulmonary artery
Creation of shunt between right ventricle and (distal) pulmonary artery
Excludes: that associated with total repair of truncus arteriosus (35.83)
35.93 Creation of conduit between left ventricle and aorta
Creation of apicoaortic shunt
Shunt between apex of left ventricle and aorta
35.94 Creation of conduit between atrium and pulmonary artery
Fontan procedure
35.95 Revision of corrective procedure on heart
Replacement of prosthetic heart valve poppet
Resuture of prosthesis of:
septum
valve
Excludes: complete revision -- code to specific procedure
replacement of prosthesis or graft of:
septum (35.50-35.63)
valve (35.20-35.28)
35.96 Percutaneous valvuloplasty
Percutaneous balloon valvuloplasty
35.98 Other operations on septa of heart
35.99 Other operations on valves of heart
36 Operations on vessels of heart
Includes: sternotomy (median) (transverse) as operative approach
thoracotomy as operative approach
Code also any:
cardiopulmonary bypass, if performed [extracorporeal circulation] [heart-lung machine] (39.61)
injection or infusion of platelet inhibitor (99.20)
injection or infusion of thrombolytic agent (99.10)
36.0 Removal of coronary artery obstruction and insertion of stent(s)
36.03 Open chest coronary artery angioplasty
Coronary (artery):
endarterectomy (with patch graft)
thromboendarterectomy (with patch graft)
Open surgery for direct relief of coronary artery obstruction
Excludes: that with coronary artery bypass graft (36.10-36.19)
Code also any:
insertion of drug-eluting coronary stent(s) (36.07)
insertion of non-drug-eluting coronary stent(s) (36.06)
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
procedure on vessel bifurcation (00.44)
36.04 Intracoronary artery thrombolytic infusion
That by direct coronary artery injection, infusion, or catheterization
Enzyme infusion
Platelet inhibitor
Excludes: infusion of platelet inhibitor (99.20)
infusion of thrombolytic agent (99.10)
that associated with any procedure in 36.03
36.06 Insertion of non-drug-eluting coronary artery stent(s)
Bare stent(s)
Bonded stent(s)
Drug-coated stent(s), i.e. heparin coated
Endograft(s)
Endovascular graft(s)
Stent grafts
Code also any:
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
open chest coronary artery angioplasty (36.03)
percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy (00.66)
procedure on vessel bifurcation (00.44)
Excludes: insertion of drug-eluting coronary artery stent(s) (36.07)
36.07 Insertion of drug-eluting coronary artery stent(s)
Endograft(s)
Endovascular graft(s)
Stent graft(s)
Code also any:
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
open chest coronary artery angioplasty (36.03)
percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy (00.66)
procedure on vessel bifurcation (00.44)
Excludes: drug-coated stents, e.g., heparin coated (36.06)
insertion of non-drug-eluting coronary artery stent(s) (36.06)
36.09 Other removal of coronary artery obstruction
Coronary angioplasty NOS
Code also any:
number of vascular stents inserted (00.45-00.48)
number of vessels treated (00.40-00.43)
procedure on vessel bifurcation (00.44)
Excludes: that by open angioplasty (36.03)
that by percutaneous transluminal coronary angioplasty [PTCA] or coronary atherectomy (00.66)
36.1 Bypass anastomosis for heart revascularization
Note: Do not assign codes from series 00.40-00.43 with codes from series 36.10-36.19
Code also : cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance, if performed (00.16)
36.10 Aortocoronary bypass for heart revascularization, not otherwise specified
Direct revascularization:
cardiac with catheter stent, prosthesis, or vein graft
coronary with catheter stent, prosthesis, or vein graft
heart muscle with catheter stent, prosthesis, or vein graft
myocardial with catheter stent, prosthesis, or vein graft
Heart revascularization NOS
36.11 (Aorto)coronary bypass of one coronary artery
36.12 (Aorto)coronary bypass of two coronary arteries
36.13 (Aorto)coronary bypass of three coronary arteries
36.14 (Aorto)coronary bypass of four or more coronary arteries
36.15 Single internal mammary-coronary artery bypass
Anastomosis (single):
mammary artery to coronary artery
thoracic artery to coronary artery
36.16 Double internal mammary-coronary artery bypass
Anastomosis, double:
mammary artery to coronary artery
thoracic artery to coronary artery
36.17 Abdominal - coronary artery bypass
Anastomosis:
Gastroepiploic - coronary artery
36.19 Other bypass anastomosis for heart revascularization
36.2 Heart revascularization by arterial implant
Implantation of:
aortic branches [ascending aortic branches] into heart muscle
blood vessels into myocardium
internal mammary artery [internal thoracic artery] into:
heart muscle
myocardium
ventricle
ventricular wall
Indirect heart revascularization NOS
36.3 Other heart revascularization
36.31 Open chest transmyocardial revascularization
36.32 Other transmyocardial revascularization
36.33 Endoscopic transmyocardial revascularization
Thoracoscopic transmyocardial revascularization
36.34 Percutaneous transmyocardial revascularization
Endovascular transmyocardial revascularization
36.39 Other heart revascularization
Abrasion of epicardium
Cardio-omentopexy
Intrapericardial poudrage
Myocardial graft:
mediastinal fat
omentum
pectoral muscles
36.9 Other operations on vessels of heart
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
36.91 Repair of aneurysm of coronary vessel
36.99 Other operations on vessels of heart
Exploration of coronary artery
Incision of coronary artery
Ligation of coronary artery
Repair of arteriovenous fistula
37 Other operations on heart and pericardium
Code also any injection or infusion of platelet inhibitor (99.20)
37.0 Pericardiocentesis
37.1 Cardiotomy and pericardiotomy
Code also cardiopulmonary bypass [extracorporeal circulation] [heart-lung machine] (39.61)
37.10 Incision of heart, not otherwise specified
Cardiolysis NOS
37.11 Cardiotomy
Incision of:
atrium
endocardium
myocardium
ventricle
37.12 Pericardiotomy
Pericardial window operation
Pericardiolysis
Pericardiotomy
37.2 Diagnostic procedures on heart and pericardium
37.20 Noninvasive programmed electrical stimulation (NIPS)
Excludes: that as part of intraoperative testing - omit code
catheter based invasive electrophysiologic testing (37.26)
device interrogation only without arrhythmia induction (bedside check) (89.45-89.49)
37.21 Right heart cardiac catheterization
Cardiac catheterization NOS
Excludes: that with catheterization of left heart (37.23)
37.22 Left heart cardiac catheterization
Excludes: that with catheterization of right heart (37.23)
37.23 Combined right and left heart cardiac catheterization
37.24 Biopsy of pericardium
37.25 Biopsy of heart