ICD-10-PCS code structure

Section:
  0 = Medical and Surgical

Body System:
  D = Gastrointestinal System

Root Operation:
  1 = Bypass

Body Part:

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See Terms used in Medical and Surgical

Select the appropriate procedure code based on the approach & device:

0D12 - Esophagus, Middle

• Open Approach

  Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure

  • Autologous Tissue Substitute
    • 0D12074 - Bypass Mid Esophag to Cutan with Autol Sub, Open Approach
    • 0D12076 - Bypass Mid Esophag to Stomach with Autol Sub, Open Approach
    • 0D12079 - Bypass Mid Esophag to Duoden with Autol Sub, Open Approach
    • 0D1207A - Bypass Mid Esophag to Jejunum with Autol Sub, Open Approach
    • 0D1207B - Bypass Mid Esophag to Ileum with Autol Sub, Open Approach
  • Synthetic Substitute
    • 0D120J4 - Bypass Mid Esophag to Cutan with Synth Sub, Open Approach
    • 0D120J6 - Bypass Mid Esophag to Stomach with Synth Sub, Open Approach
    • 0D120J9 - Bypass Mid Esophag to Duoden with Synth Sub, Open Approach
    • 0D120JA - Bypass Mid Esophag to Jejunum with Synth Sub, Open Approach
    • 0D120JB - Bypass Mid Esophag to Ileum with Synth Sub, Open Approach
  • Nonautologous Tissue Substitute
    • 0D120K4 - Bypass Mid Esophag to Cutan with Nonaut Sub, Open Approach
    • 0D120K6 - Bypass Mid Esophag to Stomach with Nonaut Sub, Open Approach
    • 0D120K9 - Bypass Mid Esophag to Duoden with Nonaut Sub, Open Approach
    • 0D120KA - Bypass Mid Esophag to Jejunum with Nonaut Sub, Open Approach
    • 0D120KB - Bypass Mid Esophag to Ileum with Nonaut Sub, Open Approach
  • No Device
    • 0D120Z4 - Bypass Middle Esophagus to Cutaneous, Open Approach
    • 0D120Z6 - Bypass Middle Esophagus to Stomach, Open Approach
    • 0D120Z9 - Bypass Middle Esophagus to Duodenum, Open Approach
    • 0D120ZA - Bypass Middle Esophagus to Jejunum, Open Approach
    • 0D120ZB - Bypass Middle Esophagus to Ileum, Open Approach

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• Percutaneous Approach

  Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach the site of the procedure

  • Synthetic Substitute
    • 0D123J4 - Bypass Mid Esophag to Cutan with Synth Sub, Perc Approach

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• Percutaneous Endoscopic Approach

  Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure

  • Autologous Tissue Substitute
    • 0D12474 - Bypass Mid Esophag to Cutan w Autol Sub, Perc Endo
    • 0D12476 - Bypass Mid Esophag to Stomach w Autol Sub, Perc Endo
    • 0D12479 - Bypass Mid Esophag to Duoden w Autol Sub, Perc Endo
    • 0D1247A - Bypass Mid Esophag to Jejunum w Autol Sub, Perc Endo
    • 0D1247B - Bypass Mid Esophag to Ileum w Autol Sub, Perc Endo
  • Synthetic Substitute
    • 0D124J4 - Bypass Mid Esophag to Cutan w Synth Sub, Perc Endo
    • 0D124J6 - Bypass Mid Esophag to Stomach w Synth Sub, Perc Endo
    • 0D124J9 - Bypass Mid Esophag to Duoden w Synth Sub, Perc Endo
    • 0D124JA - Bypass Mid Esophag to Jejunum w Synth Sub, Perc Endo
    • 0D124JB - Bypass Mid Esophag to Ileum w Synth Sub, Perc Endo
  • Nonautologous Tissue Substitute
    • 0D124K4 - Bypass Mid Esophag to Cutan w Nonaut Sub, Perc Endo
    • 0D124K6 - Bypass Mid Esophag to Stomach w Nonaut Sub, Perc Endo
    • 0D124K9 - Bypass Mid Esophag to Duoden w Nonaut Sub, Perc Endo
    • 0D124KA - Bypass Mid Esophag to Jejunum w Nonaut Sub, Perc Endo
    • 0D124KB - Bypass Mid Esophag to Ileum w Nonaut Sub, Perc Endo
  • No Device
    • 0D124Z4 - Bypass Middle Esophagus to Cutaneous, Perc Endo Approach
    • 0D124Z6 - Bypass Middle Esophagus to Stomach, Perc Endo Approach
    • 0D124Z9 - Bypass Middle Esophagus to Duodenum, Perc Endo Approach
    • 0D124ZA - Bypass Middle Esophagus to Jejunum, Perc Endo Approach
    • 0D124ZB - Bypass Middle Esophagus to Ileum, Perc Endo Approach

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• Via Natural or Artificial Opening Endoscopic Approach

  Entry of instrumentation through a natural or artificial external opening to reach and visualize the site of the procedure

  • Autologous Tissue Substitute
    • 0D12874 - Bypass Middle Esophagus to Cutaneous with Autol Sub, Endo
    • 0D12876 - Bypass Middle Esophagus to Stomach with Autol Sub, Endo
    • 0D12879 - Bypass Middle Esophagus to Duodenum with Autol Sub, Endo
    • 0D1287A - Bypass Middle Esophagus to Jejunum with Autol Sub, Endo
    • 0D1287B - Bypass Middle Esophagus to Ileum with Autol Sub, Endo
  • Synthetic Substitute
    • 0D128J4 - Bypass Middle Esophagus to Cutaneous with Synth Sub, Endo
    • 0D128J6 - Bypass Middle Esophagus to Stomach with Synth Sub, Endo
    • 0D128J9 - Bypass Middle Esophagus to Duodenum with Synth Sub, Endo
    • 0D128JA - Bypass Middle Esophagus to Jejunum with Synth Sub, Endo
    • 0D128JB - Bypass Middle Esophagus to Ileum with Synth Sub, Endo
  • Nonautologous Tissue Substitute
    • 0D128K4 - Bypass Middle Esophagus to Cutaneous with Nonaut Sub, Endo
    • 0D128K6 - Bypass Middle Esophagus to Stomach with Nonaut Sub, Endo
    • 0D128K9 - Bypass Middle Esophagus to Duodenum with Nonaut Sub, Endo
    • 0D128KA - Bypass Middle Esophagus to Jejunum with Nonaut Sub, Endo
    • 0D128KB - Bypass Middle Esophagus to Ileum with Nonaut Sub, Endo
  • No Device
    • 0D128Z4 - Bypass Middle Esophagus to Cutaneous, Endo
    • 0D128Z6 - Bypass Middle Esophagus to Stomach, Endo
    • 0D128Z9 - Bypass Middle Esophagus to Duodenum, Endo
    • 0D128ZA - Bypass Middle Esophagus to Jejunum, Endo
    • 0D128ZB - Bypass Middle Esophagus to Ileum, Endo