Q&A Excludes conventions

[LyndaH]

I am confused on the "Excludes" notes. I recently came across a coding question and I chose the wrong answer due to the Excludes note in the code. It was always my understanding when there was an excludes note, that meant the codes cannot be coded together. Just when I think I understand it, I get confused. Can you please discuss this in one of your webinars? Also, publishers have different explanations for this, making it more confusing. Thanks

Here is the question:
A patient is respirator dependent and has a tracheostomy in need of revision due to redundant scar tissue formation surrounding the site. Under general anesthesia and establishing the airways to maintain ventilation, the scar disuse is resected and then repair is accomplished using skin flap rotation from the adjacent tissue of the neck. What ICD-9 codes are reported?
a. 519.02, V55.0, V46.14
b. 709.2, 519.09, V55.0, V46.11
c. 519.02, V55.0
d. 701.4, V55.0, V46.14

 

[Luna]

Well, I'm stumped too. I've ruled out two options. But the two left don't appear correct either, precisely because of "excludes" notes. A little brush up on "excludes" might be what we need.

 

[LyndaH]

Thanks Luna, I thought it was just me

 

[Ruth Sheets]

I think this is just a bad question... V55.0 cannot be coded with 519.00 - 519.09. So a,b, and c are not good answers.
That leaves d, but V46.14 is not correct because there was no mention of mechanical complication of respirator [ventilator]. So d is incorrect, too.

I think you understand Excludes just fine.