# ? ICD-10-PCS code Axillary vein - to - Femoral vein Bypass ?



## cmontyrn (Jun 3, 2016)

I need advice on getting correct ICD-10-PCS code for inpatient surgery procedure : *Axillofemoral venous bypass*?  
Is there any AHA Coding Clinic advice on how to code this procedure ICD-10-PCS ?  
Please advise -TIA.

The documentation in medical record clearly states Axillary vein-to-Femoral vein Bypass. 

As the procedure indicates Bypass from Axillary vein (upper) to Femoral vein (lower) in ICD-10-PCS terminology, I checked in PCS index under root operation Bypass, but not finding any option(s) for bypass upper vein(s) to lower vein(s).  Is there anything I am missing? 
The ICD-10-PCS index and table 061 "Bypass lower vein" does not provide an option for the qualifier "Upper Vein" for Axillary vein.
The ICD-10-PCS index and table 051 "Bypass upper vein" does not provide an option for the qualifier "lower vein" for Femoral vein.

Per the 2017 ICD-10-PCS coding guideline B3.6a for Bypass procedures: 
Bypass procedures are coded by identifying the body part bypassed “from” and the body part bypassed “to.” The fourth character body part specifies the body part bypassed from, and the qualifier specifies the body part bypassed to.
See 2017 Official ICD-10-PCS Coding Guidelines for Bypass procedures
https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2017-Official-ICD-10-PCS-Coding-Guidelines.pdf

2016 ICD-10-PCS INDEX

*Bypass*
* Vein
* * Axillary
* * * Left 0518
* * * Right 0517
* * Femoral
* * * Left 061N
* * * Right 061M


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