Certification Review. Module 23. Medical Coding. Digestive System. Digestive System

Transcription

1 Digestive System Digestive System The digestive system is cmpsed f rgans that functin by digesting, absrbing, and eliminating fd and waste frm the bdy. The digestive system cnsists f the ral cavity (muth), thrat (pharynx), esphagus, stmach, small intestine, large intestine, liver, gallbladder, pancreas, rectum, and anus. Anatmy Oral Cavity Digestin begins with the ral cavity (r/ means muth). Fd is chewed (masticatin) and swallwed (deglutitin) t begin the digestive prcess. The fllwing structures are part f the ral cavity: Buccal cavity: Als called the vestibule f the muth Cheeks (bucc/): Inside the muth n bth sides Gums: Tissue surrunding the teeth Lips (labi/): Surrund the utside f the muth Palate (palat/): Rf f the muth Salivary glands: Excrine glands that surrund the ral cavity, which prduce saliva; saliva cntains enzymes that break dwn fd Teeth: 32 permanent teeth in the adult muth Tngue (lingu/): Muscular structure attached t the flr f the muth Tnsils: Masses f lymph tissue lcated in the back f the thrat Uvula (uvul/): Prjectin f tissue that hangs frm the palate 1

2 Pharynx (Thrat) The pharynx is a muscular tube that extends apprximately 5 t 6 inches, frm the muth t the esphagus, and serves as a passage fr air and fd. Epiglttis: Muscular flap (lid) that cvers the larynx when swallwing Esphagus The esphagus is a muscular tube that cntracts (peristalsis) and carries fd t the stmach. Stmach The stmach is a sac-like muscular rgan that lies just belw the diaphragm and t the right f the spleen. The stmach receives fd frm the esphagus. Small Intestine The small intestine is where a majrity f digestin and absrptin takes place. It is apprximately 20 feet lng and divided int three areas. Dudenum: Apprximately ne ft lng; first part f the small intestine Jejunum: Middle (secnd) part f the small intestine Ileum: Third part f the small intestine Large Intestine (Cln) The large intestine, als called the cln, includes the cecum, appendix, cln, and rectum. The large intestine begins at the end f the ileum and ends at the anus. The primary functin f the cln is t absrb large amunts f water and electrlytes and t mve feces tward the rectum. Liver Cecum: A small puch that jins the small and large intestines Appendix: (Appendage-hanging); A small tube that hangs frm the cecum in the RLQ f the abdmen; has n knwn purpse; if infected, it may lead t appendicitis requiring an appendectmy Cln: Main part f the large intestine; apprximately 5 feet lng; divided int fur areas 1. Ascending cln 2. Transverse cln 2 3. Descending cln 4. Sigmid cln Rectum: Last part f the large intestine that leads t the anus Anus: Opens t the utside f the bdy; expels feces The liver is lcated in the RUQ f the abdmen. The liver functins by making greenish fluid called bile and maintaining glucse levels in the bld. The liver releases bile thrugh ducts that lead t the gallbladder.

3 Gallbladder The gallbladder is a small pear-shaped sac that lies just belw the liver and stres bile. Pancreas The pancreas is a gland that lies behind the stmach, which functins by prducing insulin and enzymes. Surgery/Digestive System ( ) The digestive system is divided by anatmy, beginning with the muth where fd enters and ending at the anus where feces is expelled. Lips ( ) Vermilinectmy (40500): Shaving f the red part f the lips Repair (Cheilplasty)(Cleft lip and nasal defrmity, primary, tw stages) Cleft palate repairs: Partial, cmplete, unilateral r bilateral (use mdifier -50 fr bilateral) Vestibule f Muth ( ) Incisin, excisin, destructin, repair, and ther Tngue and Flr f Muth ( ) Frenum: A small flap f skin under the tngue Frentmy: Incisin perfrmed t allw mre mvement f the tngue Dentalvelar Structures ( ) Prcedures n the bne (sseus) and sft structures f the muth Palate and Uvula ( ) Uvula: Structure that hangs in the back f the thrat Salivary Gland and Ducts ( ) Prcedures are divided by anatmy: Partid, submandibular, and sublingual 2015 Cding Alert! Cde has been deleted. 3

4 Pharynx, Adenids, and Tnsils ( ) Cdes are based n surgical apprach Bipsy includes sample (des nt include the use f a scpe) Indirect laryngscpy: Viewing the larynx thrugh a reflectin Direct laryngscpy: Viewing the larynx directly thrugh a scpe Tnsillectmy and adenidectmy: Surgical remval f the tnsils and/r adenids; cde selectin based n age (yunger r lder than 12) Esphagus ( ) Based n apprach: Cervical (neck) r thracic (chest) Endscpy cdes d nt include imaging guidance (cde frm the radilgy sectin). Mst f the cdes in this subheading include cnscius sedatin Cding Alert! There are extensive changes in this subsectin, including new, deleted, and revised cdes. Be sure t read them thrughly. New guidelines added t Endscpy. Esphagscpy Cde (new) Cdes , , , , and (new instructins and resequenced) Cdes 43194, 43197, and (revised) Esphaggastrdudenscpy New guidelines added Cdes and (new instructins and resequenced) Cdes and (revised) Endscpic Retrgrade Chlangipancreatgraphy (ERCP) New guidelines added Cdes and (new instructins and resequenced) Manipulatin Cde (new instructins) 4

5 Stmach ( ) Open incisin prcedures Rux-en-Y (RNY): Y shaped surgical cnnectin; used fr intestinal bypass prcedures Bariatric prcedures: Perfrmed t treat mrbidly bese patients 2015 Cding Alert! Cde cntains new instructins. Intestines (Except Rectum) ( ) Clstmies are always bundled in a majr prcedure. Cde endscpic prcedure t the furthest extent that the scpe advances. Anastmses: Perfrmed by remving a diseased prtin f the intestine thrugh a stma (artificial pening) in the abdminal wall and rejining; there are three types: 1. End t end 2. End t side 3. Side t side Extensive add-n cdes in this sectin (add-n cdes may nt be cded alne) Cde is mdifier -51 exempt 2015 Cding Alert! There are extensive changes in this subsectin, including new and revised cdes as well as new guidelines. Be sure t read them thrughly. Endscpy, Small Intestine New guidelines Cdes and (revised) Cdes (new instructins) Endscpy, Stmal New title and guidelines Cdes 44380, , and (revised) Cdes 44382, 44389, and (new instructins) Cdes 44381, 44384, and (new) Other Prcedures Cde (revised) Meckel s Diverticulum and the Mesentery ( ) Meckel s diverticulum is a cngenital puch n the wall f the small intestine that may require surgical remval (44800) 5

6 Appendix ( ) Appendicitis: Inflammatin f the appendix; usually affects yung adults; treatment is appendectmy; pen r thrugh a scpe When a healthy appendix is remved during anther pen prcedure, the prcedure is incidental and, therefre, is nt cded. Cde selectin is based n apprach (pen, percutaneusly, r thrugh a scpe). Cln and Rectum ( ) Prcedures divided by anatmy: Rectum, sigmid cln, and cln Cding Alert! There are extensive changes in this subsectin, including new and revised cdes as well as new guidelines. Be sure t read them thrughly. Endscpy Anus ( ) New guidelines added Cdes 45330, , 45337, 45340, , , and (revised) Cdes , , , 45393, and (new and resequenced) Hemrrhids: inflammatin arund the anus; may be inside r utside; cde based n extent 1. First degree: Bleeding, n prtrusin utside f the anus 2. Secnd degree: Prtrudes utside the anus ccasinally 3. Third degree: Prtrudes utside ften 4. Furth degree: Cannt be manually placed back inside the anus; may be strangulated 2015 Cding Alert! Cdes 46221, 46500, 46606, and cntain new instructins. Cde has been revised. Cdes and are new. Liver ( ) Transplant is very cmplex; usually requires a team f surgens (use mdifiers) 2015 Cding Alert! Cde is new. Biliary Tract ( ) Prcedures n the gallbladder 6

7 Pancreas ( ) Prcedures perfrmed due t pancreatitis (inflammatin f the pancreas); diabetes patients. Abdmen, Peritneum, and Omentum ( ) Use t reprt a diagnstic laparscpy. Hernia cdes are based n type f hernia Cding Alert! Cdes and cntain new instructins. 7