Odds are, most coders will never use ICD-10-PCS table 0W4. Why? Because root operation 4 is creation (making a new genital structure that does not physically take the place of a body part). Unless the physician is performing a sex change operation, you won’t report creation.
If you do code for these procedures, you have a very small table. You have only two choices for a fourth character:
- M, perineum, male
- N, perineum, female
You pick the fourth character based on the current gender of the patient. The qualifier (seventh character) identifies the body part being created (0 for vagina, 1 for penis).
The approach is always open. The only other information you need is the device, and you have four choices:
- 7, autologous tissue substitute
- J, synthetic substitute
- K, nonautologous tissue substitute
- Z, no device
If the physician harvests tissue from the patient to create the new penis or vagina, report a code for the harvesting procedure in addition to the creation operation. The seventh character for the creation in this case would be 7.
If the tissue comes from a donor tissue bank, use the seventh character K. You would only report the creation procedure.