ICD-10-PCS The complete official code setCodes valid October 1, 2016through September 30, 2017

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ICD-10-PCS 2017 i

ContentsPreface ....................................................................................iii

What’s New for 2017 ...............................................................v

New Features for 2017 ............................................................x

Introduction .............................................................................1History of ICD-10-PCS ................................................................................1Number of Codes in ICD-10-PCS ...........................................................2ICD-10-PCS Manual ....................................................................................2Medical and Surgical Section (0) ...........................................................5Obstetrics Section (1) ................................................................................9Placement Section (2) ...............................................................................9Administration Section (3) .....................................................................10Measurement and Monitoring Section (4) ........................................11Extracorporeal Assistance and Performance Section (5) ...............11Extracorporeal Therapies Section (6) ..................................................12Osteopathic Section (7) ..........................................................................13Other Procedures Section (8) ................................................................13Chiropractic Section (9) ..........................................................................13Imaging Section (B) .................................................................................14Nuclear Medicine Section (C) ................................................................14Radiation Therapy Section (D) ..............................................................15Physical Rehabilitation and Diagnostic Audiology Section (F) .....15Mental Health Section (G) ......................................................................16Substance Abuse Treatment Section (H) ...........................................17New Technology Section (X) .................................................................18Appendixes ................................................................................................19Comparison of ICD-10-PCS and ICD-9-CM ........................................20Conclusion ................................................................................................20

ICD-10-PCS Index and Tabular Format ..................................21Index ............................................................................................................21Code Tables ...............................................................................................21

ICD-10-PCS Additional Features ............................................25Use of Official Sources .............................................................................25Table Notations ........................................................................................25Index Notations ........................................................................................26

ICD-10-PCS Official Guidelines for Coding and Reporting 2017 ......................................................................27

Conventions ..............................................................................................27Medical and Surgical Section Guidelines (section 0) ......................28Obstetric Section Guidelines (section 1) ............................................31New Technology Section Guidelines (section X) ..............................32Selection of Principal Procedure ..........................................................32

Coding Exercises ...................................................................33Medical Surgical Section ........................................................................33Obstetrics ...................................................................................................36Placement ..................................................................................................36Administration ..........................................................................................36Measurement and Monitoring .............................................................37Extracorporeal Assistance and Performance ....................................37Extracorporeal Therapies .......................................................................37Osteopathic ...............................................................................................37Other Procedures .....................................................................................37Chiropractic ...............................................................................................37Imaging ......................................................................................................37Nuclear Medicine .....................................................................................38Radiation Therapy ....................................................................................38Physical Rehabilitation and Diagnostic Audiology ..........................38Mental Health ...........................................................................................38Substance Abuse Treatment .................................................................38New Technology ......................................................................................38

ICD-10-PCS Tables ............................................................... 131Central Nervous System ................................................................131Peripheral Nervous System ................................................................ 148Heart and Great Vessels ....................................................................... 163Upper Arteries ........................................................................................ 179Lower Arteries ........................................................................................ 200Upper Veins ............................................................................................ 218Lower Veins ............................................................................................ 234Lymphatic and Hemic Systems ......................................................... 251Eye ............................................................................................................ 267Ear, Nose, Sinus ...................................................................................... 283Respiratory System ............................................................................... 304Mouth and Throat ................................................................................. 316Gastrointestinal System ...................................................................... 332Hepatobiliary System and Pancreas ................................................. 353Endocrine System ................................................................................. 363Skin and Breast ...................................................................................... 373Subcutaneous Tissue and Fascia ....................................................... 388Muscles .................................................................................................... 404Tendons ................................................................................................... 423Bursae and Ligaments ......................................................................... 435Head and Facial Bones ......................................................................... 453Upper Bones ........................................................................................... 471Lower Bones ........................................................................................... 487Upper Joints ........................................................................................... 502Lower Joints ........................................................................................... 520Urinary System ....................................................................................... 539Female Reproductive System ............................................................ 554Male Reproductive System ................................................................. 569Anatomical Regions, General ............................................................. 581Anatomical Regions, Upper Extremities .......................................... 591Anatomical Regions, Lower Extremities .......................................... 599Obstetrics ................................................................................................ 607Placement ............................................................................................... 611Administration ....................................................................................... 617Measurement and Monitoring .......................................................... 630Extracorporeal Assistance and Performance ................................. 635Extracorporeal Therapies .................................................................... 637Osteopathic ............................................................................................ 639Other Procedures .................................................................................. 640Chiropractic ............................................................................................ 642Imaging ................................................................................................... 643Nuclear Medicine .................................................................................. 676Radiation Therapy ................................................................................. 687Physical Rehabilitation and Diagnostic Audiology ....................... 703Mental Health ........................................................................................ 718Substance Abuse Treatment .............................................................. 721New Technology ................................................................................... 724

Appendixes ......................................................................... 727Appendix A: Components of the Medical and Surgical

Approach Definitions .......................................................... 727Appendix B: Root Operation Definitions ......................................... 728Appendix C: Comparison of Medical and Surgical Root

Operations .............................................................................. 734Appendix D: Body Part Key ................................................................. 736Appendix E: Body Part Definitions .................................................... 752Appendix F: Device Key and Aggregation Table ........................... 764Appendix G: Device Definitions ......................................................... 773Appendix H: Substance Key/Substance Definitions ..................... 779Appendix I: Sections B–H Character Definitions ........................... 780Appendix J: Hospital Acquired Conditions ..................................... 790Appendix K: Answers to Coding Exercises ...................................... 799Appendix L: Procedure Combination Tables ................................. 806

Brachytherapy — continuedMediastinum DB16Mouth D914Nasopharynx D91DNeck and Head DW11Nerve, Peripheral D017Nose D911Oropharynx D91FOvary DU10Palate

Hard D918Soft D919

Pancreas DF13Parathyroid Gland DG14Pelvic Region DW16Pineal Body DG11Pituitary Gland DG10Pleura DB15Prostate DV10Rectum DD17Sinuses D917Spinal Cord D016Spleen D712Stomach DD11Testis DV11Thymus D711Thyroid Gland DG15Tongue D915Trachea DB10Ureter DT11Urethra DT13Uterus DU12

Brachytherapy seeds use Radioactive ElementBroad ligament use Uterine Supporting StructureBronchial artery use Upper ArteryBronchography

see Fluoroscopy, Respiratory System BB1see Plain Radiography, Respiratory System BB0

Bronchoplastysee Repair, Respiratory System 0BQsee Supplement, Respiratory System 0BU

Bronchorrhaphy see Repair, Respiratory System 0BQBronchoscopy 0BJ08ZZBronchotomy see Drainage, Respiratory System 0B9Bronchus Intermedius use Main Bronchus, RightBRYAN® Cervical Disc System use Synthetic SubstituteBuccal gland use Buccal MucosaBuccinator lymph node use Lymphatic, HeadBuccinator muscle use Muscle, FacialBuckling, scleral with implant see Supplement, Eye

08UBulbospongiosus muscle use Muscle, PerineumBulbourethral (Cowper's) gland use UrethraBundle of His use Conduction MechanismBundle of Kent use Conduction MechanismBunionectomy see Excision, Lower Bones 0QBBursectomy

see Excision, Bursae and Ligaments 0MBsee Resection, Bursae and Ligaments 0MT

Bursocentesis seeDrainage, Bursae and Ligaments 0M9Bursography

see Plain Radiography, Non-Axial Lower Bones BQ0see Plain Radiography, Non-Axial Upper Bones BP0

Bursotomysee Division, Bursae and Ligaments 0M8see Drainage, Bursae and Ligaments 0M9

BVS 5000 Ventricular Assist DeviceuseExternal HeartAssist System in Heart and Great Vessels

BypassAnterior Chamber

Left 08133Right 08123

AortaAbdominal 0410Thoracic

Ascending/Arch 021XDescending 021W

ArteryAxillary

Left 03160Right 03150

BrachialLeft 03180Right 03170

Common CarotidLeft 031J0Right 031H0

Bypass — continuedArtery — continued

Common IliacLeft 041DRight 041C

CoronaryFour or More Arteries 0213One Artery 0210Three Arteries 0212Two Arteries 0211

External CarotidLeft 031N0Right 031M0

External IliacLeft 041JRight 041H

FemoralLeft 041LRight 041K

Innominate 03120Internal Carotid

Left 031L0Right 031K0

Internal IliacLeft 041FRight 041E

Intracranial 031G0Popliteal

Left 041NRight 041M

PulmonaryLeft 021RRight 021Q

Pulmonary Trunk 021PRadial

Left 031C0Right 031B0

Splenic 0414Subclavian

Left 03140Right 03130

TemporalLeft 031T0Right 031S0

UlnarLeft 031A0Right 03190

AtriumLeft 0217Right 0216

Bladder 0T1BCavity, Cranial 0W110JCecum 0D1HCerebral Ventricle 0016Colon

Ascending 0D1KDescending 0D1MSigmoid 0D1NTransverse 0D1L

DuctCommon Bile 0F19Cystic 0F18Hepatic

Left 0F16Right 0F15

LacrimalLeft 081YRight 081X

Pancreatic 0F1DAccessory 0F1F

Duodenum 0D19Ear

Left 091E0Right 091D0

Esophagus 0D15Lower 0D13Middle 0D12Upper 0D11

Fallopian TubeLeft 0U16Right 0U15

Gallbladder 0F14Ileum 0D1BJejunum 0D1AKidney Pelvis

Left 0T14Right 0T13

Pancreas 0F1GPelvic Cavity 0W1J

Bypass — continuedPeritoneal Cavity 0W1GPleural Cavity

Left 0W1BRight 0W19

Spinal Canal 001UStomach 0D16Trachea 0B11Ureter

Left 0T17Right 0T16

Ureters, Bilateral 0T18Vas Deferens

Bilateral 0V1QLeft 0V1PRight 0V1N

VeinAxillary

Left 0518Right 0517

Azygos 0510Basilic

Left 051CRight 051B

BrachialLeft 051ARight 0519

CephalicLeft 051FRight 051D

Colic 0617Common Iliac

Left 061DRight 061C

Esophageal 0613External Iliac

Left 061GRight 061F

External JugularLeft 051QRight 051P

FaceLeft 051VRight 051T

FemoralLeft 061NRight 061M

FootLeft 061VRight 061T

Gastric 0612Greater Saphenous

Left 061QRight 061P

HandLeft 051HRight 051G

Hemiazygos 0511Hepatic 0614Hypogastric

Left 061JRight 061H

Inferior Mesenteric 0616Innominate

Left 0514Right 0513

Internal JugularLeft 051NRight 051M

Intracranial 051LLesser Saphenous

Left 061SRight 061R

Portal 0618Renal

Left 061BRight 0619

Splenic 0611Subclavian

Left 0516Right 0515

Superior Mesenteric 0615Vertebral

Left 051SRight 051R

Vena CavaInferior 0610Superior 021V

Brachytherapy—

BypassIndex

432 Subterms under main terms may continue to next column or page

BypassICD-10-PCS 2017

Bypass — continuedVentricle

Left 021LRight 021K

Bypass, cardiopulmonary 5A1221Z

CCaesarean section see Extraction, Products of Concep-

tion 10D0Calcaneocuboid joint

use Joint, Tarsal, Leftuse Joint, Tarsal, Right

Calcaneocuboid ligamentuse Bursa and Ligament, Foot, Leftuse Bursa and Ligament, Foot, Right

Calcaneofibular ligamentuse Bursa and Ligament, Ankle, Leftuse Bursa and Ligament, Ankle, Right

Calcaneususe Tarsal, Leftuse Tarsal, Right

Cannulationsee Bypasssee Dilationsee Drainagesee Irrigation

Canthorrhaphy see Repair, Eye 08QCanthotomy see Release, Eye 08NCapitate bone

use Carpal, Leftuse Carpal, Right

Capsulectomy, lens see Excision, Eye 08BCapsulorrhaphy, joint

see Repair, Lower Joints 0SQsee Repair, Upper Joints 0RQ

Cardia use Esophagogastric JunctionCardiac contractility modulation lead use Cardiac

Lead in Heart and Great VesselsCardiac event recorder use Monitoring DeviceCardiac Lead

DefibrillatorAtrium

Left 02H7Right 02H6

Pericardium 02HNVein, Coronary 02H4Ventricle

Left 02HLRight 02HK

Insertion of device inAtrium

Left 02H7Right 02H6

Pericardium 02HNVein, Coronary 02H4Ventricle

Left 02HLRight 02HK

PacemakerAtrium

Left 02H7Right 02H6

Pericardium 02HNVein, Coronary 02H4Ventricle

Left 02HLRight 02HK

Removal of device from, Heart 02PARevision of device in, Heart 02WA

Cardiac plexus use Nerve, Thoracic SympatheticCardiac Resynchronization Defibrillator Pulse Gen-

eratorAbdomen 0JH8Chest 0JH6

Cardiac Resynchronization Pacemaker Pulse Gener-ator

Abdomen 0JH8Chest 0JH6

Cardiac resynchronization therapy (CRT) leaduse Cardiac Lead, Defibrillator in 02Huse Cardiac Lead, Pacemaker in 02H

Cardiac Rhythm Related DeviceInsertion of device in

Abdomen 0JH8Chest 0JH6

Cardiac Rhythm Related Device — continuedRemoval of device from, Subcutaneous Tissue and

Fascia, Trunk 0JPTRevision of device in, Subcutaneous Tissue and Fascia,

Trunk 0JWTCardiocentesis see Drainage, Pericardial Cavity 0W9DCardioesophageal junction use Esophagogastric

JunctionCardiolysis see Release, Heart and Great Vessels 02NCardioMEMS® pressure sensoruseMonitoring Device,

Pressure Sensor in 02HCardiomyotomy seeDivision, Esophagogastric Junction

0D84Cardioplegia see Introduction of substance in or on,

Heart 3E08Cardiorrhaphy see Repair, Heart and Great Vessels 02QCardioversion 5A2204ZCaregiver Training F0FZCaroticotympanic artery

use Artery, Internal Carotid, Leftuse Artery, Internal Carotid, Right

Carotid glomususe Carotid Bodies, Bilateraluse Carotid Body, Leftuse Carotid Body, Right

Carotid sinususe Artery, Internal Carotid, Leftuse Artery, Internal Carotid, Right

Carotid (artery) sinus (baroreceptor) lead use Stimu-lator Lead in Upper Arteries

Carotid sinus nerve use Nerve, GlossopharyngealCarotid WALLSTENT® Monorail® Endoprosthesisuse

Intraluminal DeviceCarpectomy

see Excision, Upper Bones 0PBsee Resection, Upper Bones 0PT

Carpometacarpal (CMC) jointuse Joint, Metacarpocarpal, Leftuse Joint, Metacarpocarpal, Right

Carpometacarpal ligamentuse Bursa and Ligament, Hand, Leftuse Bursa and Ligament, Hand, Right

Casting see ImmobilizationCAT scan see Computerized Tomography (CT Scan)Catheterization

see Dilationsee Drainagesee Insertion of device insee IrrigationHeart see Measurement, Cardiac 4A02Umbilical vein, for infusion 06H033T

Cauda equina use Spinal Cord, LumbarCauterization

see Destructionsee Repair

Cavernous plexususeNerve, Head and Neck Sympathet-ic

Cecectomysee Excision, Cecum 0DBHsee Resection, Cecum 0DTH

Cecocolostomysee Bypass, Gastrointestinal System 0D1see Drainage, Gastrointestinal System 0D9

Cecopexysee Repair, Cecum 0DQHsee Reposition, Cecum 0DSH

Cecoplication see Restriction, Cecum 0DVHCecorrhaphy see Repair, Cecum 0DQHCecostomy

see Bypass, Cecum 0D1Hsee Drainage, Cecum 0D9H

Cecotomy see Drainage, Cecum 0D9HCeftazidime-Avibactam Anti-infective XW0Celiac ganglion use Nerve, Abdominal SympatheticCeliac lymph node use Lymphatic, AorticCeliac (solar) plexususeNerve, Abdominal SympatheticCeliac trunk use Artery, CeliacCentral axillary lymph node

use Lymphatic, Axillary, Leftuse Lymphatic, Axillary, Right

Central venous pressure see Measurement, Venous4A04

Centrimag® Blood Pump use External Heart Assist Sys-tem in Heart and Great Vessels

Cephalogram BN00ZZZ

Ceramic on ceramic bearing surface use SyntheticSubstitute, Ceramic in 0SR

Cerclage see RestrictionCerebral aqueduct (Sylvius) use Cerebral VentricleCerebral Embolic Filtration, Dual Filter X2A5312Cerebrum use BrainCervical esophagus use Esophagus, UpperCervical facet joint

use Joint, Cervical Vertebraluse Joint, Cervical Vertebral, 2 or more

Cervical ganglionuseNerve, Head and Neck Sympathet-ic

Cervical interspinous ligament use Bursa and Liga-ment, Head and Neck

Cervical intertransverse ligamentuseBursa and Liga-ment, Head and Neck

Cervical ligamentum flavum use Bursa and Ligament,Head and Neck

Cervical lymph nodeuse Lymphatic, Neck, Leftuse Lymphatic, Neck, Right

Cervicectomysee Excision, Cervix 0UBCsee Resection, Cervix 0UTC

Cervicothoracic facet joint use Joint, CervicothoracicVertebral

Cesarean section seeExtraction, Products of Conception10D0

Change device inAbdominal Wall 0W2FXBack

Lower 0W2LXUpper 0W2KX

Bladder 0T2BXBone

Facial 0N2WXLower 0Q2YXNasal 0N2BXUpper 0P2YX

Bone Marrow 072TXBrain 0020XBreast

Left 0H2UXRight 0H2TX

Bursa and LigamentLower 0M2YXUpper 0M2XX

Cavity, Cranial 0W21XChest Wall 0W28XCisterna Chyli 072LXDiaphragm 0B2TXDuct

Hepatobiliary 0F2BXPancreatic 0F2DX

EarLeft 092JXRight 092HX

Epididymis and Spermatic Cord 0V2MXExtremity

LowerLeft 0Y2BXRight 0Y29X

UpperLeft 0X27XRight 0X26X

EyeLeft 0821XRight 0820X

Face 0W22XFallopian Tube 0U28XGallbladder 0F24XGland

Adrenal 0G25XEndocrine 0G2SXPituitary 0G20XSalivary 0C2AX

Head 0W20XIntestinal Tract

Lower 0D2DXUZUpper 0D20XUZ

JawLower 0W25XUpper 0W24X

JointLower 0S2YXUpper 0R2YX

Kidney 0T25XLarynx 0C2SX

2 Subterms under main terms may continue to next column or page44

ICD-10-PCS 2017BypassIn

dex

Bypa

ss—

Cha

nge

devi

ce in

Central Nervous System

ICD-10-PCS 2017 131

ICD-10-PCS Tables

Central Nervous System 001–00XCharacter Meanings This Character Meaning table is provided as a guide to assist the user in the identification of character members that may be found in this section of code tables. It SHOULD NOT be used to build a PCS code.

Operation–Character 3 Body Part–Character 4 Approach–Character 5 Device–Character 6 Qualifier–Character 7

1 Bypass 0 Brain 0 Open 0 Drainage Device 0 Nasopharynx 2 Change 1 Cerebral Meninges 3 Percutaneous 2 Monitoring Device 1 Mastoid Sinus 5 Destruction 2 Dura Mater 4 Percutaneous Endoscopic 3 Infusion Device 2 Atrium 8 Division 3 Epidural Space X External 7 Autologous Tissue

Substitute 3 Blood Vessel

9 Drainage 4 Subdural Space J Synthetic Substitute 4 Pleural Cavity B Excision 5 Subarachnoid Space K Nonautologous Tissue

Substitute 5 Intestine

C Extirpation 6 Cerebral Ventricle M Neurostimulator Lead 6 Peritoneal Cavity D Extraction 7 Cerebral Hemisphere Y Other Device 7 Urinary Tract F Fragmentation 8 Basal Ganglia Z No Device 8 Bone Marrow H Insertion 9 Thalamus 9 Fallopian Tube J Inspection A Hypothalamus B Cerebral Cisterns K Map B Pons F Olfactory Nerve N Release C Cerebellum G Optic Nerve P Removal D Medulla Oblongata H Oculomotor Nerve Q Repair E Cranial Nerve J Trochlear Nerve S Reposition F Olfactory Nerve K Trigeminal Nerve T Resection G Optic Nerve L Abducens Nerve U Supplement H Oculomotor Nerve M Facial Nerve W Revision J Trochlear Nerve N Acoustic Nerve X Transfer K Trigeminal Nerve P Glossopharyngeal Nerve

L Abducens Nerve Q Vagus Nerve M Facial Nerve R Accessory Nerve N Acoustic Nerve S Hypoglossal Nerve P Glossopharyngeal Nerve X Diagnostic Q Vagus Nerve Z No Qualifier R Accessory Nerve S Hypoglossal Nerve T Spinal Meninges U Spinal Canal V Spinal Cord W Cervical Spinal Cord X Thoracic Spinal Cord Y Lumbar Spinal Cord

AHA Coding Clinic for table 0012015, 2Q, 9 Revision of ventriculoperitoneal (VP) shunt2013, 2Q, 36 Insertion of ventriculoperitoneal shunt with laparoscopic assistance

AHA Coding Clinic for table 0092015, 3Q, 10 Open evacuation of subdural hematoma2015, 3Q, 11 Percutaneous drainage of subdural hematoma2015, 3Q, 12 Subdural evacuation portal system (SEPS) placement2015, 3Q, 12 Placement of ventriculostomy catheter via burr hole2015, 2Q, 26 Drainage of syrinx2015, 1Q, 31 Intrathecal chemotherapy2014, 1Q, 8 Diagnostic lumbar tap2014, 1Q, 8 Lumbar drainage port aspiration

AHA Coding Clinic for table 00B2016, 2Q, 12 Resection of malignant neoplasm of infratemporal fossa2016, 2Q, 18 Amygdalohippocampectomy2014, 4Q, 34 Resection of brain malignancy with implantation of chemotherapeutic

wafer2014, 3Q, 24 Repair of lipomyelomeningocele and tethered cord

AHA Coding Clinic for table 00C2016, 2Q, 29 Decompressive craniectomy with cryopreservation and storage of bone flap2015, 3Q, 10 Open evacuation of subdural hematoma2015, 3Q, 11 Percutaneous drainage of subdural hematoma2015, 3Q, 13 Evacuation of intracerebral hematoma

AHA Coding Clinic for table 00D2015, 3Q, 13 Nonexcisional debridement of cranial wound with removal and replacement of

hardware

AHA Coding Clinic for table 00H2014, 3Q, 19 End of life replacement of Baclofen pump

AHA Coding Clinic for table 00N2016, 2Q, 29 Decompressive craniectomy with cryopreservation and storage of bone flap2015, 2Q, 18 Cervical laminoplasty2015, 2Q, 19 Multiple decompressive cervical laminectomies2014, 3Q, 24 Repair of lipomyelomeningocele and tethered cord

AHA Coding Clinic for table 00P2014, 3Q, 19 End of life replacement of Baclofen pump

AHA Coding Clinic for table 00Q2014, 3Q, 7 Hemi-cranioplasty for repair of cranial defect2013, 3Q, 25 Fracture of frontal bone with repair and coagulation for hemostasis

AHA Coding Clinic for table 00S2014, 4Q, 35 Reimplantation of buccal nerve

AHA Coding Clinic for table 00U2015, 4Q, 39 Dural patch graft2014, 3Q, 24 Repair of lipomyelomeningocele and tethered cord

ICD-10-PCS 2017 Heart and Great Vessels 021–025 Heart and G

reat Vessels021–025

3 Limited Coverage 4 Noncovered ? Combination Member HAC associated procedure Combination Only DRG Non-OR Non-OR New/Revised in GREENICD-10-PCS 2017 167

0 Medical and Surgical 021 Continued2 Heart and Great Vessels 0211 Bypass Definition: Altering the route of passage of the contents of a tubular body part

Explanation: Rerouting contents of a body part to a downstream area of the normal route, to a similar route and body part, or to an abnormal route and dissimilar body part. Includes one or more anastomoses, with or without the use of a device.

Body PartCharacter 4

ApproachCharacter 5

DeviceCharacter 6

QualifierCharacter 7

P Pulmonary TrunkQ Pulmonary Artery, Right R Pulmonary Artery, Left

0 Open4 Percutaneous Endoscopic

8 Zooplastic Tissue9 Autologous Venous TissueA Autologous Arterial TissueJ Synthetic SubstituteK Nonautologous Tissue SubstituteZ No Device

A Innominate Artery B SubclavianD Carotid

W Thoracic Aorta, Descending X Thoracic Aorta, Ascending/Arch

Aortic archAscending aorta

0 Open4 Percutaneous Endoscopic

8 Zooplastic Tissue9 Autologous Venous TissueA Autologous Arterial TissueJ Synthetic SubstituteK Nonautologous Tissue SubstituteZ No Device

B SubclavianD CarotidP Pulmonary TrunkQ Pulmonary Artery, RightR Pulmonary Artery, Left

0 Medical and Surgical2 Heart and Great Vessels 0254 Creation Definition: Putting in or on biological or synthetic material to form a new body part that to the extent possible replicates the anatomic structure

or function of an absent body partExplanation: Used for gender reassignment surgery and corrective procedures in individuals with congenital anomalies

Body PartCharacter 4

ApproachCharacter 5

DeviceCharacter 6

QualifierCharacter 7

F Aortic ValveAortic annulus

0 Open 7 Autologous Tissue8 Zooplastic TissueJ Synthetic SubstituteK Nonautologous Tissue Substitute

J Truncal Valve

G Mitral ValveBicuspid valveLeft atrioventricular valveMitral annulus

J Tricuspid ValveRight atrioventricular valveTricuspid annulus

0 Open 7 Autologous Tissue8 Zooplastic TissueJ Synthetic SubstituteK Nonautologous Tissue Substitute

2 Common Atrioventricular Valve

0 Medical and Surgical2 Heart and Great Vessels 0255 Destruction Definition: Physical eradication of all or a portion of a body part by the direct use of energy, force, or a destructive agent

Explanation: None of the body part is physically taken out

Body PartCharacter 4

ApproachCharacter 5

DeviceCharacter 6

QualifierCharacter 7

4 Coronary Vein5 Atrial Septum

Interatrial septum6 Atrium, Right

Atrium dextrum cordisRight auricular appendixSinus venosus

8 Conduction MechanismAtrioventricular nodeBundle of HisBundle of KentSinoatrial node

9 Chordae TendineaeD Papillary MuscleF Aortic Valve

Aortic annulusG Mitral Valve

Bicuspid valveLeft atrioventricular valveMitral annulus

H Pulmonary ValvePulmonary annulusPulmonic valve

J Tricuspid ValveRight atrioventricular valveTricuspid annulus

K Ventricle, RightConus arteriosus

L Ventricle, LeftM Ventricular Septum

Interventricular septumN PericardiumP Pulmonary TrunkQ Pulmonary Artery, RightR Pulmonary Artery, Left

Arterial canal (duct)Botallo's ductPulmoaortic canal

S Pulmonary Vein, RightRight inferior pulmonary veinRight superior pulmonary

veinT Pulmonary Vein, Left

Left inferior pulmonary veinLeft superior pulmonary vein

V Superior Vena CavaPrecava

W Thoracic Aorta, Descending X Thoracic Aorta, Ascending/

ArchAortic archAscending aorta

0 Open3 Percutaneous4 Percutaneous Endoscopic

Z No Device Z No Qualifier

7 Atrium, LeftAtrium pulmonaleLeft auricular appendix

0 Open3 Percutaneous 4 Percutaneous Endoscopic

Z No Device K Left Atrial Appendage Z No Qualifier

DRG Non-OR 0257[0,3,4]ZK

ICD-10-PCS 2017 Heart and Great Vessels 02H–02J Heart and G

reat Vessels02H

–02J

3 Limited Coverage 4 Noncovered ? Combination Member HAC associated procedure Combination Only DRG Non-OR Non-OR New/Revised in GREENICD-10-PCS 2017 171

0 Medical and Surgical2 Heart and Great Vessels 02HH Insertion Definition: Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically

take the place of a body partExplanation: None

Body PartCharacter 4

ApproachCharacter 5

DeviceCharacter 6

QualifierCharacter 7

4 Coronary Vein ?6 Atrium, Right ?

Atrium dextrum cordisRight auricular appendixSinus venosus

7 Atrium, Left ?Atrium pulmonaleLeft auricular appendix

K Ventricle, Right ?Conus arteriosus

L Ventricle, Left ?

0 Open 3 Percutaneous4 Percutaneous Endoscopic

0 Monitoring Device, Pressure Sensor2 Monitoring Device 3 Infusion Device D Intraluminal Device J Cardiac Lead, PacemakerK Cardiac Lead, DefibrillatorM Cardiac Lead N Intracardiac Pacemaker

Z No Qualifier

A Heart 34 0 Open3 Percutaneous4 Percutaneous Endoscopic

Q Implantable Heart Assist System Z No Qualifier

A Heart ? 0 Open3 Percutaneous4 Percutaneous Endoscopic

R External Heart Assist System S BiventricularZ No Qualifier

N Pericardium ? 0 Open 3 Percutaneous 4 Percutaneous Endoscopic

0 Monitoring Device, Pressure Sensor2 Monitoring DeviceJ Cardiac Lead, Pacemaker K Cardiac Lead, DefibrillatorM Cardiac Lead

Z No Qualifier

P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left

Arterial canal (duct)Botallo's ductPulmoaortic canal

S Pulmonary Vein, Right Right inferior pulmonary veinRight superior pulmonary vein

T Pulmonary Vein, Left Left inferior pulmonary veinLeft superior pulmonary vein

V Superior Vena Cava Precava

W Thoracic Aorta, DescendingX Thoracic Aorta, Ascending/Arch

Aortic archAscending aorta

0 Open 3 Percutaneous 4 Percutaneous Endoscopic

0 Monitoring Device, Pressure Sensor2 Monitoring Device3 Infusion Device D Intraluminal Device

Z No Qualifier

DRG Non-OR 02H[4,6,7][0,4][J,M]ZDRG Non-OR 02H[6,7]3JZDRG Non-OR 02H[K,L][0,3,4][J,M]ZNon-OR 02H[4,7,L]3[2,3]ZNon-OR 02H[6,K]32ZNon-OR 02HN32ZNon-OR 02HP[0,3,4][0,2,3]ZNon-OR 02H[Q,R][0,3,4][2,3]ZNon-OR 02H[S,T,V][0,4]3ZNon-OR 02H[S,T,V]3[2,3]ZNon-OR 02HW[0,4][0,3]ZNon-OR 0SHW3[0,2,3]Z

HAC 02H43[J,K,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA

HAC 02H[6,7]3[J,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA

HAC 02H[K,L]3JZ when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA

HAC 02HN[0,3,4][J,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA

3 02HA0QZ4 02HA[3,4]QZ

See Appendix L for Procedure CombinationsCombo-only 02H[4,6,7,K,L][0,4][J,M]ZCombo-only 02H[K,L]3MZ? 02H[4,6,7]3[J,M]Z? 02H[K,L]3JZ? 02H[4,6,7,L][0,3,4]KZ? 02HK[0,3,4][0,2,K]Z? 02HA[0,4]R[S,Z]? 02HA3RS? 02HN[0,3,4][J,K,M]Z

0 Medical and Surgical2 Heart and Great Vessels 02JJ Inspection Definition: Visually and/or manually exploring a body part

Explanation: Visual exploration may be performed with or without optical instrumentation. Manual exploration may be performed directly or through intervening body layers.

Body PartCharacter 4

ApproachCharacter 5

DeviceCharacter 6

QualifierCharacter 7

A HeartY Great Vessel

0 Open3 Percutaneous4 Percutaneous Endoscopic

Z No Device Z No Qualifier

Non-OR 02J[A,Y]3ZZ

Upper Arteries ICD-10-PCS 2017

Up

per A

rter

ies

180 ICD-10-PCS 2017

Upper Arteries

Head and Neck Arteries

Appendix L: Procedure Combination Tables ICD-10-PCS 2017

812 ICD-10-PCS 2017

App

endi

x L:

Pro

cedu

re C

ombi

nati

on T

able

s

DRG 518-520 Back and Neck Procedures, Except Spinal Fusion, or Disc Devices/Neurostimulators

DRG 582-583 Mastectomy for Malignancy

DRG 584-585 Breast Biopsy, Local Excision and Other Breast proceduresResection of Breast With Resection of Lymph Nodes and Thorax Muscle

Replacement of Breast Tissue

DRG 628-630 Other Endocrine, Nutritional and Metabolic ProceduresOpen Removal of Hip Joint Spacer, Liner, or Resurfacing Device With Supplement of Liner

Generator TypeInsertion of Generator by Site

Code also as appropriate Insertion Neurostimulator Lead by approach and

Site

Chest Abdomen Back Spinal Canal Spinal Cord

Single Array 0JH6[0,3]BZ 0JH8[0,3]BZ 0JH7[0,3]BZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ

Single Array, Rechargeable 0JH6[0,3]CZ 0JH8[0,3]CZ 0JH7[0,3]CZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ

Multiple Array 0JH6[0,3]DZ 0JH8[0,3]DZ 0JH7[0,3]DZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ

Multiple Array, Rechargeable 0JH6[0,3]EZ 0JH8[0,3]EZ 0JH7[0,3]EZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ

SiteResection by

Open approach

Code also as appropriate Resection of Lymph Nodes by Open approach by site

Code also as appropriate Resection of Thorax Muscle by Open approach

Axillary Internal Mammary Thorax Right Left

Breast, Right 0HTT0ZZ 07T50ZZ 07T80ZZ 07T70ZZ 0KTH0ZZ —

Breast, Left 0HTU0ZZ 07T60ZZ 07T90ZZ 07T70ZZ — 0KTJ0ZZ

Breast, Bilateral 0HTV0ZZ 07T50ZZ and

07T60ZZ07T80ZZ and

07T90ZZ07T70ZZ 0KTH0ZZ 0KTJ0ZZ

SiteResection by

Open approach

Code also as appropriate Resection of Lymph Nodes by Open approach by site

Code also as appropriate Resection of Thorax Muscle by Open approach

Axillary Internal Mammary Thorax Right Left

Breast, Right 0HTT0ZZ 07T50ZZ 07T80ZZ 07T70ZZ 0KTH0ZZ —

Breast, Left 0HTU0ZZ 07T60ZZ 07T90ZZ 07T70ZZ — 0KTJ0ZZ

Breast, Bilateral 0HTV0ZZ 07T50ZZ and 07T60ZZ 07T80ZZ and 07T90ZZ 07T70ZZ 0KTH0ZZ 0KTJ0ZZ

Site

Replacement by Percutaneous approach with

Autologous Tissue

Code also as appropriate Extraction of Subcutaneous Tissue by Percutaneous approach

Abdomen Back Buttock Chest Leg, Upper, Right

Leg, Upper, Left

Breast, Right 0HRT37Z 0JD83ZZ 0JD73ZZ 0JD93ZZ 0JD63ZZ 0JDL3ZZ 0JDM3ZZ

Breast, Left 0HRU37Z 0JD83ZZ 0JD73ZZ 0JD93ZZ 0JD63ZZ 0JDL3ZZ 0JDM3ZZ

Breast, Bilateral 0HRV37Z 0JD83ZZ 0JD73ZZ 0JD93ZZ 0JD63ZZ 0JDL3ZZ 0JDM3ZZ

Body PartRemoval

Spacer/Liner/Resurfacing Device

Code also as appropriate Supplement of Body Part

Joint Acetabular Surface Femoral Surface

Hip, RT 0SP90[8,9,B]Z 0SU909Z 0SUA09Z 0SUR09Z

Hip, LT 0SPB0[8,9,B]Z 0SUB09Z 0SUE09Z 0SUS09Z