Review the case study below and code the correct procedure(s)using ICD-10-PCS. Provide the rationale for your codeselection.
PREOPERATIVE DIAGNOSIS: Obstructive jaundice.
POSTOPERATIVE DIAGNOSIS: Pancreatic head mass.
SURGICAL PROCEDURES: EUS with FNA.
After informed consent was obtained, the patient receivedsedation with IV 10 mg Versed and IV 200 mcg of fentanyl foradequate sedation. The linear echo endoscope was first passedthrough the mouth down the esophagus to the extent of the duodenalbulb. The scope could not pass beyond the duodenal bulb into thedescending duodenum due to the nature of her anatomy. The celiacaxis was first scanned from the stomach and was grossly normal withno lymphadenopathy seen. The body and tail of the pancreas werescanned from the stomach at which point that the pancreatic ductwas seen to be very irregular in nature and also dilated toapproximately 5-6 mm. The parenchyma appeared very atrophic as wellof the pancreas in the body and tail. No lymphadenopathy seen near.The scope was then advanced to the duodenal bulb through thepylorus into the duodenal bulb at which point a pancreatic headmass was seen. This mass appeared was very vague to differentiatefrom the normal pancreatic parenchyma, but appeared to be roughly 3× 2 cm when scanned from the duodenal bulb. There appeared to be noinvasion of the superior mesenteric artery and no invasion of theportal vein. There was seen a clean plane between these 2structures. The percutaneous drain appeared to be extending intothis mass. From the duodenal bulb, 3 biopsies were taken with the22-gauge FNA needle. Three passes made through the duodenal wall ofthe pancreatic head lesion and sent for cytology, and cell block.There was maybe one 2 mm lymph nodes seen at this level, but againno definite vascular invasion was seen. The scope was then removedand the procedure complete.
ANESTHESIA TYPE: Conscious sedation.
ESTIMATED BLOOD LOSS: Minimal.
SPECIMENS REMOVED: FNA of the pancreatic head mass ×3 with a 22gauge needle through the duodenal wall.
FINDINGS: Pancreatic head mass measuringroughly 3 × 2 cm. Local collaterals seen, but no apparent invasionof the confluence, the portal vein or the superior mesentericartery. Unable to pass the scope into duodenum for a fullevaluation of this lesion.
RECOMMEND: Await cytology results.
Looking for the correct ICD-10-PCS code for this. I used0FBG8ZX. Not sure if it is correct or not. Can you clarify?