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Jennifer McElroy, CPC
AHIMA Approved ICD-10 CM/PCS Trainer
ICD-10 PCS CODING 101
AGENDA• ICD -10 PCS Guidelines & Conventions
• Medical Surgical
• Body Part vs Body System
• Root Operations
• Approaches
• Device
• Qualifiers
• Case Studies
• The Gray Section
• Case Studies
ICD-10-PCS OVERVIEW• Conventions & Guidelines
• ICD-10-PCS Codes are 7 characters
• The letters I and O are excluded
• Built in room for growth
• Alpha index
• Characters 1 - 3
• Characters 4 – 7
ICD-10-PCS• Body Part Vs. Body System
VS
Mouth & Throat Frenulum linguae
ICD-10-PCS• Body Part Vs. Body System
VS
Aortic Arch Heart and Great Vessels
ICD-10-PCS• Body Part Vs. Body System
VS
Gastrointestinal Sigmoid Colon
ICD-10-PCS MEDICAL SURGICAL• Root Operations
Medical and Surgical Section Root Operations
Alteration Division Inspection Reposition
Bypass Drainage Map Resection
Change Excision Occlusion Restriction
Control Extirpation Reattachment Revision
Creation Extraction Release Supplement
Destruction Fragmentation Removal Transfer
Detachment Fusion Repair Transplantation
Dilation Insertion Replacement
ICD-10-PCS MEDICAL SURGICAL• Root operations
Extraction (D)
ICD-10-PCS MEDICAL SURGICAL• Root operations
Detachment (6)
ICD-10-PCS MEDICAL SURGICAL• Root operations
Transfer (X)
ICD-10-PCS MEDICAL SURGICAL• Root operations
Alteration (0)
ICD-10-PCS MEDICAL SURGICAL• Approaches
• Open (0)
• Percutaneous (3)
• Percutaneous Endoscopic (4)
• Via Natural or Artificial Opening (7)
• Via Natural or Artificial Opening Endoscopic (8)
• Via Natural or Artificial Opening with Percutaneous Endoscopic Assist (F)
• External (X)
ICD-10-PCS MEDICAL SURGICAL• Approaches
Via Natural or Artificial Opening (7)
ICD-10-PCS MEDICAL SURGICAL• Approaches
Via Natural or Artificial opening
with percutaneous Endoscopic
Assistance (F)
ICD-10-PCS MEDICAL SURGICAL• Approaches
Percutaneous (3)
ICD-10-PCS MEDICAL SURGICAL• Approaches
External (X)
ICD-10-PCS MEDICAL SURGICAL• Approaches
Open (0)
ICD-10-PCS MEDICAL SURGICAL• Approaches
Percutaneous Endoscopic (4)
ICD-10-PCS MEDICAL SURGICAL• Approaches
Via Natural or artificial opening
endoscopic
ICD -10 PCS MEDICAL SURGICAL• Devices
• Biological or synthetic material that takes the place of all or a portion of a body part (e.g. skin graft)
• Biological or synthetic material that assists or prevents a physiological function (e.g. urinary catheter, IUD)
• Therapeutic material that is not absorbed by, eliminated by, or incorporated into a body part (e.g. radioactive implant) Therapeutic materials that are considered devices can be removed.
• Mechanical or electronic appliances used to assist, monitor, take the place of, or prevent a physiological function (e.g. diaphragmatic pacemaker, orthopedic pins)
ICD -10 PCS MEDICAL SURGICAL• Qualifier
• Allogeneic (0)
• Syngeneic (1)
• Zooplastic (2)
• Diagnostic (X)
ICD-10-PCS CASE STUDIES• 3.9
• Procedure Performed: Subtotal gastrectomy with Billroth II anastomosis
0DB60ZZ Excision, Stomach Gastrectomy, Partial
0D160ZA – Bypass, Stomach
0DHA0UZ – Insertion of device in, jejunum
ICD-10-PCS CASE STUDIES• 3.13
• Procedure Performed: Left initial inguinal hernia repair with mesh
0YU60JZ – Supplement, inguinal region left, herniorrhaphy with sythetic substitute
ICD-10-PCS CASE STUDIES• 3.38
• Procedure Performed: Exploratory laparotomy, sigmoid colectomy, extended right hemicolectomy, colostomy.
• CODE ONLY PCS codes0DTN0ZZ – Resection, Colon, Sigmoid
0DTF0ZZ – Resection, Intestine, Large Right Hemicolectomy
0DBL0ZZ – Excision, Colon, Transverse
0D1M0Z4 – Bypass, Colon Descending Colostomy
ICD-10-PCS - OBSTETRICS• Root Operations (2 added)
• Abortion (A)
• Delivery (E)
• Body Parts
• Products of Conception
• Products of Conception, retained
• Products of Conception, ectopic
ICD-10 PCS - PLACEMENT• Root Operations
• Compression (1)
• Dressing (2)
• Immobilization (3)
• Packing (4)
• Traction(6)
ICD-10 PCS - ADMINISTRATION• Body Systems
• Circulatory system
• Indwelling Device
• Physiological Systems and Anatomical Regions
• Root operations
• Introduction
• Irrigation
• Transfusion
ICD-10 PCS – MEASUREMENT & MONITORING
• Measurement – Determining the level of a physiological or physical function at a point in time.
• Monitoring – Determining the level of physiological or physical function repetitively over a period of time.
ICD-10 PCS – EXTRACORPEAL• Extracorpeal Assistance and Performance
• Root Operations
• Assistance
• Performance
• Restoration
ICD-10 PCS – EXTRACORPEAL• Extracorpeal Therapies
• Root Operations
• Atmospheric Control
• Decompression
• Electromagnetic Therapy
• Hyperthermia
• Hypothermia
• Pheresis
• Ultrsound Therapy
• Ultraviolet Light Therapy
• Shock wave Therapy
ICD-10 PCS OSTEOPATHIC, OTHER & CHIROPRACTIC• Osteopathic Section
• Root Operation – Treatment
• Other Procedures Section
• Root Operation – Other procedures
• Chiropractic
• Root Operation - Manipulation
ICD-10 ANCILLARY SECTION• Imaging (B)
• Nuclear Medicine (C)
• Radiation Oncology (D)
• Physical Rehabilitation and Diagnostic Audiology (F)
• Mental Health (G)
• Substance Abuse Treatment (H)
ICD-10-PCS CASE STUDIES• 3.41
• Procedure Performed: Transvaginal abortion using vacuum aspiration technique.
10A07Z6 – Abortion, Vacuum
ICD-10-PCS CASE STUDIES• 3.43
• Procedure Performed: Fetal spinal tap, percutaneous
10903ZA – Drainage, Products of Conception, Fetal cerebrospinal fluid
ICD-10-PCS CASE STUDIES• 3.79
• Procedure Performed: Alcohol detoxification treatment
HZ2ZZZZ – Dextoxification Services for substance abuse
REFERENCES• ICD-10-PCS Coder Training Manual, 2013 Edition (AHIMA Press)
• ICD-10-PCS Official Guidelines for Coding and Reporting