c. Four digit subcategory codes which provide greater specificity in identifying
anatomical sites and defining selected procedures, techniques, or the surgical
approach. When a three-digit code is followed by a four-digit code, the four-digit code
must be used. The four-digit codes are also used to differentiate between unilateral and
bilateral, and between types of conditions such as direct and indirect hernia.
32.2 Local excision or destruction of lesion or tissue
32.21 Plication of emphysematous bleb
32.29 Other local excision or destruction of
lesion or tissue of lung
4. The two instructions unique to Volume 3 are:
a. Omit code.
b. Code also any synchronous procedure.
5. The following guidelines are to be used for coding procedures:
a. The surgical approach and closure as part of the operation do not require
additional codes. Procedures such as laparotomy are not coded if used as an approach
for a surgical procedure such as excision or repair.
b. When a biopsy is performed as part of a more extensive surgical procedure,
code both the biopsy and surgical procedure.
c. If a procedure is started and not completed, the approach (incision) is coded.
6. Instructions for Coding Procedures/Use of Alphabetic Index Volume 3
a. Use the Alphabetic Index to locate the main term (procedure): excision, incision,
graft, control, etc.
b. Read and be guided by any note that appears under the main term such as
"see" and "see also."
c. Read any terms enclosed in parentheses (modifiers) following the main entry as
well as subterms indented under the main entry for selection of the appropriate code.
d. Follow any cross -reference instructions.
e. Do not code from the Alphabetic Index, important instructions appear in the
Tabular List. Verify the code number in the Tabular List.