When making a comparison of the ICD-10 PCS code structure to that

of the ICD-9 PCS code structure; the coder should throw everything

out the window and start from scratch while keeping the following in

mind:

ICD-10 PCS is comprised of 16 sections represented by the numbers 0-

9 and the letters B-D and F-H. The 16 sections are subdivided into

main sections: Medical & Surgical; Medical & Surgical-related and

Ancillary Sections.

All codes in the Medical & Surgical Section begin with 0 and contain

the majority of procedures used in the inpatient setting.

All codes in ICD-10 PCS are 7 characters in length and each of the

characters represent an aspect of the procedure. The 7 characters in

the Medical & Surgical Section are: Medical & Surgical, Body

System, Root Operation, Body Part, Approach, Device, and Qualifier

respectively.

1st Character=Medical Surgical

2nd Character=Body System

3rd Character=Root Operation

4th

Character=Body Part

5th

Character=Approach

6th

Character=Device

7th

Character=Qualifier

Medical & Surgical

(0)

Body System

Root Operatio

n

Body Part

Approach

Device

Qualifier

THE STRUCTURE OF THE CODE

WHAT TO EXPECT

1 The Structure of the Code

2 Body Systems & Root

Operations

3 What is a Valid Code?

4 Requests for Coding Topics

May 2015

Volume 2 Issue 4

By Cynthia Brown, MBA, RHIT, CCS

www.cyntcodinghealthinformationservices.com

CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984 Gain Knowledge of Medical Coding Through E -Learning Cynth ia@cyntcodinghealthinformat ionserv ices.com [phone]

CODING YESTERDAY’S NOMENCLATURE TODAY®

ICD-10 PCS MEDICAL & SURGICAL SECTION

CODE STRUCTURE

CODING NEWSLETTER FOR HEALTHCARE

CODING PROFESSIONALS

Page 2 Coding Yesterday’s Nomenclature Today

There are 31 Body Systems in the Medical & Surgical Section along

with 31 Root Operations (not all are used in each Body System).

BODY SYSTEMS:

The procedure codes in the general anatomical regions should only be

used when the procedure is performed on an anatomical region rather

than a specific body part or when there is no information available to

support a specific body part.

ROOT OPERATIONS:

In order to determine the appropriate root operation, the full definition

of the root operation as defined in the PCS Tables must be applied.

The coder should take full advantage of the definition keys found in the

Tables and Index. They are the Body Part Key, Device Key, Substance

Key, and Device Aggregation Key.

Purchase the “ICD-10 PCS Medical & Surgical Reference Guide” for

more guidelines and reference material; which is found at https://sites.google.com/a/cyntcodinghealthinformationservices.com/gain-knowledge-of-medical-coding-through-e-learning/e-books.

www.cyntcodinghealthinformationservices.com

CNS PNS

Heart

& Great Vessels

Upper Arteries

Lower Arteries

Upper Veins

Lower Veins

Lymphatic & Hemic Systems

Eye

ENT

Respiratory

System

Mouth & Throat

Gastrointestinal

System

Hepatobiliary System &

Pancreas

Endocrine System

Skin & Breast

Subcutaneous

Tissue &

Fascia

Muscles Tendons

Bursae &

Ligaments

Head & Facial Bones

Upper Bones

Lower Bones

Upper Joints

Lower Joints

Urinary System

Female Reproducti

ve

System

Male Reproducti

ve

System

Anatomical Regions

General

Anatomical Regions

Upper Extremitie

s

Anatomical Regions

Lower Extremitie

s

Excision Resection Detachme

nt Destruction Extraction Drainage

Extirpation

Fragmentation

Division

Release

Transplantation

Reattachment

Transfer Repositio

n Restrictio

n Occlusion Dilation Bypass Insertion

Replacement

Supplement

Change Removal Revision Inspection Map Repair Control Fusion Alteration

Creation

“Take advantage of the definition

keys”

The full definition of the root

operation must be applied.

BODY SYSTEMS & ROOT OPERATIONS

Coding Yesterday’s Nomenclature Today

WHAT IS A VALID CODE? To produce a valid 7 character code, the coder must refer to ICD-10 PCS Tables and

Index. The alphabetic index is used to locate the appropriate table used in building a

code. The table should ALWAYS be used when determining the appropriate

procedural code. A unique feature of ICD-10 PCS is the coder’s ability to obtain a

complete and accurate code by using the table only. This is not true in ICD-9 PCS;

the coder must first refer to the alphabetic index and then cross-check the code using

the Tabular List. All seven characters must be specified for there to be a valid code.

Query the physician for more specificity when one of the characters cannot be

specified.

Within the PCS Table, valid codes include all combinations of choices in character 4

through 7 contained in the SAME row of the table. The numbers 0 through 9 are

used to specify characters in ICD-10 PCS along with the letters of the alphabets with

the exception of the letters O and I.

Compare the codes with the table to help you differentiate between valid and invalid

PCS codes.

Valid Codes:

08123J4 08133J4 081X0J3 081X3J3 081Y0J3 081Y3J3

08123K4 08133K4 081X0K3 081X3K3 081Y0K3 081Y3K3

08123Z4 08133Z4 081X0Z3 081X3Z3 081Y0Z3 081Y3Z3

Notice how the characters are contained in the same row for each of the codes.

Invalid Codes:

08120J4 08130J4 08123J3 08133J3

08120K4 08130K4 OR 08123K3 08133K3

08120Z4 08130Z4 08123Z3 08133Z3

Notice there is not an “Open” Approach character for “Body Parts” Anterior

Chamber, Right or Left. If you stay on the same row as the “Body Parts” Anterior

Chamber Right or Left; the only option for the “Approach” is Percutaneous.

In the second set of invalid codes, the “Qualifier” Sclera Cavity cannot be used for the

“Body Parts” Anterior Chamber, Right or Left. The “Qualifier” Sclera Cavity is not on

the same row as the “Body Parts” Anterior Chamber, Right or Left. Your only option

for the “Body Parts” Anterior Chamber, Right or Left “Qualifier” is Sclera; because it

is on the same row.

Section 0 Medical and Surgical

Body System 8 Eye

Root Operation 1 Bypass Body Part Approach Device Qualifier

2 Ant. Chamber, RT

3 Ant. Chamber, LT

3 Percutaneous J Synthetic Substitute

K Nonautologous Tissue

Z No Device

4 Sclera

X Lacrimal Duct, RT

Y Lacrimal Duct. LT

0 Open

3 Percutaneous

J Synthetic Substitute

K Nonautologous Tissue

Z No Device

3 Sclera Cavity

www.cyntcodinghealthinformationservices.com

AHIMA Approved ICD-10 CM/PCS

Trainer

ALL THINGS CODING®

“Accurate and

complete coding is a

must in today’s

economically

challenged healthcare

environment.”

Page 4 Coding Yesterday’s Nomenclature Today

CCHIS Professional Affiliates

AHIMA GHIMA AHIMA approved ICD-10 CM/PCS

Trainer EDWOSB/WOSB VOSB SCORE Atlanta

CyntCoding Health Information Services P.O. BOX 3019 Decatur, GA 30031

Phone: 404-992-8984

E-Fax: 678-805-4919

E-mail: cyntcoder@cyntcodinghealthinformationservices.com

Requests for coding topics: E-mail your coding topics or view FREE issues of the CCHIS Newsletter by visiting the website. You may also purchase your coding e-books from the site. Contact me at: cyntcoder@cyntcodinghealthinformationservices.com.

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