ICD-10 PCS: Procedure Coding Operations that take Solids, Fluids or Gases from a Body Part by Dr. Helen Walker

Drainage (Root Operation 9) is defined as taking or letting out fluids or gases from a body part This is used for both diagnostic and therapeutic drainage procedures. Examples include Foley catheter placement, paracentesis, thoracentesis, incision and drainage of an abscess, chest tube placement, I & D of a cyst, and drainage of ethmoid sinus.

Coding Example: urinary nephrostomy catheter placement

Extirpation (Root Operation C) is defined as taking or cutting out solid matter or material from a body part. This does not involve surgery on the body part but instead focuses on removing solid material from the body part. Example include a foreign body, thrombus, or calculus. Extirpation procedures include thrombectomy, removal of foreign body, choledocholithotomy, endarterectomy and removal of calculus.

Coding Example: De-clotting of AV dialysis graft

Fragmentation (Root Operation F) is the breaking apart of solid matter in a body part into pieces-think lithotripsy.  The solid matter is fragmented and not removed but eliminated or absorbed. Examples of fragmentation includes extracorporeal shockwave lithotripsy, transurethral cystoscopy with fragmentation of calculus, endoscopic retrograde cholangiopancreatography with lithotripsy, and transurethral lithotripsy.

Coding Example: ESWL of left kidney:

Reference: CMS: “2010 ICD-10-PCS Reference Manual” Available online at www.cms.hhs.gov/ICD10