For facilities performing CABG and other sternotomy procedures, readmission due to problems associated with sternal wires is just one type of complication that can occur post-operatively. The types of complications that can occur due to sternal wires include persistent pain, infection displacement, sternal dehiscence, and fractured wires. Most of these complications will require removal of the sternal wires. The 2019 Third Quarter Coding Clinic (P. 19) provided advice regarding what PCS code should be reported for removal of sternal wires:
The patient, who is status post coronary artery bypass graft (CABG), presents with painful protruding sternal wires. At surgery, the previous incision was opened and sternal wires were removed. How should the removal of sternal wire be coded?
Assign the following ICD-10-PCS code:
0PC00ZZ Extirpation of matter from sternum, open approach, for the removal of sternal wire
While this does not seem like a complex coding scenario, the advice provided does not seem intuitive and I am quite sure that many coders (myself included) would have coded: 0PP004Z Removal of fixation device from the sternum, open approach. To ensure data quality please make sure all coders are aware of this advice if your facility is performing sternotomy procedures where readmissions for sternal wire removal might be performed.