# Stent Exchange Diagnosis Codes



## ckkohler (Jul 11, 2017)

We do a number of ureteral stent exchanges in our ASC.  The ICD-10 diagnoses I assign are T19.1XXA, Z46.6 with the 3rd one being the reason for the stent to begin with ... with hydronephrosis being the most common.  My question is two-fold.  

1. Does it matter what sequence the codes are in?
2. For those patients that have the stent permanently and return for an exchange every 6 months or so...should the 7 character to a D?

Thanks for any assistance you can provide.


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## mitchellde (Jul 11, 2017)

You should not be using the T19.1xx- codes for routine stent exchange encounters. Use just the Z46.6 as the first listed code and only if the condition of hydronephrosis is still present would you add it as a secondary.  You should not treat a therapeutic device as a foreign body.


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## ckkohler (Jul 12, 2017)

Thank you, Debra!  Can you point me to a good resource that supports this information?  I tried GOOGL'ng a thousand different ways.  Thanks again!


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## ckkohler (Jul 12, 2017)

*Add'l Stent Questions*

Debra, 
So, I've been pondering your response as it applies to the 3rd diagnosis in a stent exchange.  If a patient has a continuous stent - wouldn't the condition still be active (i.e. as in hydronephrosis)?  With regard to stents in general - for stent removal (i.e. 52310 or 52315), I've been advised to use T19.1XXA, Z46.6 and then again the "reason" the stent was placed in the first place .. such as kidney or ureteral stone.  Is this not correct either?

I don't get a lot of help from the coding supervisor here and admit I have gaps in my coding knowledge.  So, any additional help you can provide, including a place to find information myself, would be very much appreciated.

Thank you!!


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## mitchellde (Jul 16, 2017)

The chapter for all S and T codes is labeled "Injury, poisoning and certain other consequences of external causes S00-T88"
The normal exchange of a stent does not meet this criteria.  If there was a malfunction of the stent then you would use a complication code.
The Section "Effects of foreign body entering through natural orifice T15-T19" is  for a foreign body that enters through a natural orifice.  If a provider inserts a stent with the patient's consent, then it is not a foreign body, it is a therapeutic device.  A foreign body is something the patient does not willing allow to enter into their body like a toothpick sliver that is accidentally swallowed.., then you would use a code from this section.


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