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male where the procedure is performed is the perineum. The device of tissue bank donor material is nonautologous or other human tissue. The Qualifier identifies that a vagina is being created. 25. Answer: 0H0V0JZ Character Code Explanation Section 0 Medical and Surgical Body System H Skin and Breast Root Operation 0 Alteration Body Part V Breast, Bilateral Approach 0 Open Device J Synthetic Substitute Qualifier Z Qualifier INDEX: Root Operation: Alteration. Coder must recognize this is a cosmetic procedure, therefore, the root operation is alteration. Index: Alteration, breast, bilateral (0H0V) The silicone implants are the device which is a synthetic substitute. 26. Answer: 00HV3MZ Character Code Explanation Section 0 Medical and Surgical Body System 0 Central Nervous System Root Operation H Insertion Body Part V Spinal Cord Approach 3 Percutaneous Device M Neurostimulator Lead Qualifier Z No Qualifier INDEX: Root Operation: Insertion. Index: Insertion of device in, spinal cord (00HV). The device is a neurostimulator which is inserted into lumbar spinal cord by percutaneous approach. 27. Answer: 0UUG0JZ Character Code Explanation Section 0 Medical and Surgical Body System U Female Reproductive System Root Operation U Supplement Body Part G Vagina Approach 0 Open Device J Synthetic Substitute Qualifier Z No Qualifier INDEX: Root Operation: Supplement. Index: Colporrhaphy see Repair, Vagina (0UQG) When reviewing this table, coder will note there is no device character to identify the mesh used. So this is not the correct root operation. The definition of supplement is putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a body part. The insertion of mesh is a “supplement” procedure that reinforces the structure of the body part. The Index entry to be used is Supplement, vagina (0UUG). Mesh is a synthetic product. 28. Answer: 0B21XFZ Character Code Explanation Section 0 Medical and Surgical Body System B Respiratory System Root Operation 2 Change Body Part 1 Trachea Approach X External Device F Tracheostomy Device Qualifier Z No Qualifier INDEX: Root Operation: Change. Index: Exchange see Change device in, trachea (0B21). An exchange procedure is removing and reinserting the same or similar device into the same location. A tracheostomy tube exchange involved a device in the trachea. The approach is external the tracheostomy opening is accessed directly at the skin level. 29. Answer: 00K00ZZ Character Code Explanation Section 0 Medical and Surgical Body System 0 Central Nervous System Root Operation K Map Body Part 0 Brain Approach 0 Open Device Z No Device Qualifier Z No Qualifier INDEX: Root Operation: Map. Index: Map, brain (00K0). The approach is open as described by the craniotomy. There is no device left in the body after the procedure and no qualifier listed on the code table.

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