An Intro to Coding Procedures in ICD-10-PCS by Dr. Helen Walker
ICD-10-PCS has 16 sections.
- The three sections that will concern us the most are Medical and surgical, Obstetrics and Mental health.
The Procedure codes contain seven characters
- The 1st character relates to one of the 16 sections noted above. For example, “0” indicates Medical and Surgical while “1” indicates Obstetrics.
- The 2nd character indicates the Body system
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- There are 31 values including traditional body systems (Lungs, heart) and expanded categories (Upper bones, lower bones)
- The 3rd character indicates the Root operation
- These are new and not in ICD-9-PCS
- There are 31 root operations (i.e. resection, revision) –more on this topic later
- The 4th character indicates the Body part (i.e. liver, lungs)
- There are 34 possible body parts in each body system
- The 5th character indicates the Approach (i.e. open, percutaneous)
- There are 7 different approaches
- The 6th character indicates the Device (i.e. grafts, implants)
- These are devices that remain after the procedure is completed
- The 7th character indicates a Qualifier if it exists; may have different meanings depending upon the procedure.
Let’s analyze a Procedure code: 0FT44ZZ 0 – The Procedure is found in the Medical and Surgical Section of ICD-10-PCS F – It involves the Hepatobiliary System and Pancreas T – The operation is a resection 4 – The body part is the gallbladder 4 – The approach is percutaneous, endoscopic Z – No device was used Z – There is no Qualifier There are No Eponyms in the Procedure Index. In ICD-9 you might look up Billroth II procedure to find the corresponding code. This term does not exist in ICD-10. Instead you would have to know that the Billroth II procedure involves a partial gastrectomy with anastomosis to the jejunum. ICD-10 has Greater specificity and more codes
- In ICD-9 there are less than 20 anatomical sites for angioplasty. In ICD-10 there are more than 1,000 codes for angioplasty and requires listing the specified vessel.