Q&A: ICD-10-PCS coding for neobladder reconstruction

Q: What is a neobladder reconstruction and how is this procedure reported in ICD-10-PCS?

A: Neobladder reconstruction is the surgical construction of a new bladder using intestinal tissue. This surgery may be performed if a patient has bladder cancer, a non-functional bladder, or urinary incontinence that is unresponsive to treatment. It is reported with ICD-10-PCS root operation Transfer because the intestinal tissue is moved to another area of the body to form the new bladder. The piece of the intestine that is moved remains connected to its vascular and nervous supply.

This new bladder will enable the patient to urinate voluntarily. It may be referred to as an orthotopic bladder, meaning the bladder is in the exact same place as the native bladder and/or ureter.

The 2023 ICD-10-PCS code update introduced four new codes for neobladder reconstruction procedures:

• 0DX80ZB, Transfer of small intestine to bladder, open approach
• 0DX80ZC, Transfer of small intestine to right ureter, open approach
• 0DX80ZD, Transfer of small intestine to left ureter, open approach
• 0DX80ZF, Transfer of small intestine to bilateral ureters, open approach

Editor’s note: This article question was answered by Kimberly Cunningham, CCS, CPC, instructor for the Certified Coder Bootcamp programs at HCPro in Middleton, Massachusetts, during the webinar, “JustCoding's 2023 ICD-10-PCS Code Updates.” This Q&A originally appeared in JustCoding Inpatient.