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2019

ICD-10-PCS Expert The complete official code set

Codes valid from October 1, 2018 through September 30, 2019

EXPERT

ITPC_ITPCS19_CVR.indd 1 12/4/17 2:18 PM

ICD-10-PCS 2019 i

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

What’s New for 2019 ...............................................................v

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) ................................................................................8Placement Section (2) ...............................................................................9Administration Section (3) .....................................................................10Measurement and Monitoring Section (4) ........................................10Extracorporeal or Systemic Assistance and

Performance Section (5) ........................................................11Extracorporeal or Systemic Therapies Section (6) ...........................11Osteopathic Section (7) ..........................................................................12Other Procedures Section (8) ................................................................13Chiropractic Section (9) ..........................................................................13Imaging Section (B) .................................................................................13Nuclear 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) .................................................................17Appendixes ................................................................................................18

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

ICD-10-PCS Additional Features ............................................23Use of Official Sources .............................................................................23Table Notations ........................................................................................23Index Notations ........................................................................................24

ICD-10-PCS Official Guidelines for Coding and Reporting 2019 ...............................................................25

Conventions ..............................................................................................25Medical and Surgical Section Guidelines (section 0) ......................26Obstetric Section Guidelines (section 1) ............................................30New Technology Section Guidelines (section X) ..............................30Selection of Principal Procedure ..........................................................30

ICD-10-PCS Tables ...............................................................125Central Nervous System and Cranial Nerves ................................ 125Peripheral Nervous System ................................................................ 145Heart and Great Vessels ....................................................................... 163Upper Arteries ........................................................................................ 183Lower Arteries ........................................................................................ 205Upper Veins ............................................................................................ 227Lower Veins ............................................................................................ 245Lymphatic and Hemic Systems ......................................................... 263Eye ............................................................................................................ 281Ear, Nose, Sinus ...................................................................................... 299Respiratory System ............................................................................... 319Mouth and Throat ................................................................................. 335Gastrointestinal System ...................................................................... 353Hepatobiliary System and Pancreas ................................................. 381Endocrine System ................................................................................. 395Skin and Breast ...................................................................................... 405Subcutaneous Tissue and Fascia ....................................................... 419Muscles .................................................................................................... 437Tendons ................................................................................................... 459Bursae and Ligaments ......................................................................... 473

Head and Facial Bones ......................................................................... 495Upper Bones ........................................................................................... 515Lower Bones ........................................................................................... 535Upper Joints ........................................................................................... 553Lower Joints ........................................................................................... 571Urinary System ....................................................................................... 593Female Reproductive System ............................................................ 609Male Reproductive System ................................................................. 629Anatomical Regions, General ............................................................. 643Anatomical Regions, Upper Extremities .......................................... 653Anatomical Regions, Lower Extremities .......................................... 663Obstetrics ................................................................................................ 673Placement ............................................................................................... 677Administration ....................................................................................... 683Measurement and Monitoring .......................................................... 697Extracorporeal or Systemic Assistance and Performance ........... 703Extracorporeal or Systemic Therapies ............................................. 705Osteopathic ............................................................................................ 707Other Procedures .................................................................................. 709Chiropractic ............................................................................................ 711Imaging ................................................................................................... 713Nuclear Medicine .................................................................................. 747Radiation Therapy ................................................................................. 759Physical Rehabilitation and Diagnostic Audiology ....................... 775Mental Health ........................................................................................ 791Substance Abuse Treatment .............................................................. 795New Technology ................................................................................... 799

Appendixes ......................................................................... 803Appendix A: Components of the Medical and

Surgical Approach Definitions .........................................803Appendix B: Root Operation Definitions ......................................... 805Appendix C: Comparison of Medical and Surgical

Root Operations .................................................................... 811Appendix D: Body Part Key ................................................................. 813Appendix E: Body Part Definitions .................................................... 829Appendix F: Device Key and Aggregation Table ........................... 841Appendix G: Device Definitions ......................................................... 851Appendix H: Substance Key/Substance Definitions ..................... 857Appendix I: Sections B–H Character Definitions ........................... 859Appendix J: Hospital Acquired Conditions ..................................... 869Appendix K: Coding Exercises and Answers ................................... 899Appendix L: Procedure Combination Tables ................................. 913

Sample

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Bypass — continuedVein — continued

Internal Jugular — continuedRight 051M

Intracranial 051LPortal 0618Renal

Left 061BRight 0619

SaphenousLeft 061QRight 061P

Splenic 0611Subclavian

Left 0516Right 0515

Superior Mesenteric 0615Vertebral

Left 051SRight 051R

Vena CavaInferior 0610Superior 021V

VentricleLeft 021LRight 021K

Bypass, cardiopulmonary 5A1221Z

CCaesarean section see Extraction, Products of Concep-

tion 10D0Calcaneocuboid joint

use Tarsal Joint, Leftuse Tarsal Joint, Right

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

Calcaneofibular ligamentuse Ankle Bursa and Ligament, Leftuse Ankle Bursa and Ligament, 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 02H4

Cardiac Lead — continuedPacemaker — continued

VentricleLeft 02HLRight 02HK

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

Cardiac plexus use Thoracic Sympathetic NerveCardiac 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

Removal of device from, Subcutaneous Tissue andFascia, Trunk 0JPT

Revision of device in, Subcutaneous Tissue and Fascia,Trunk 0JWT

Cardiocentesis 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 Internal Carotid Artery, Leftuse Internal Carotid Artery, Right

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

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

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

Carotid sinus nerve use Glossopharyngeal NerveCarotid WALLSTENT® Monorail® Endoprosthesisuse

Intraluminal DeviceCarpectomy

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

Carpometacarpal ligamentuse Hand Bursa and Ligament, Leftuse Hand Bursa and Ligament, 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 plexususeHead and Neck Sympathetic NerveCBMA (Concentrated Bone Marrow Aspirate) use

Concentrated Bone Marrow AspirateCBMA (Concentrated Bone Marrow Aspirate) injec-

tion, intramuscular XK02303Cecectomy

see Excision, Cecum 0DBHsee Resection, Cecum 0DTH

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

Cecopexysee Repair, Cecum 0DQH

Cecopexy — continuedsee 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 Abdominal Sympathetic NerveCeliac lymph node use Lymphatic, AorticCeliac (solar) plexususeAbdominal Sympathetic NerveCeliac trunk use Celiac ArteryCentral axillary lymph node

use Lymphatic, Left Axillaryuse Lymphatic, Right Axillary

Central venous pressure see Measurement, Venous4A04

Centrimag® Blood Pumpuse Short-term External HeartAssist System in Heart and Great Vessels

Cephalogram BN00ZZZCeramic on ceramic bearing surface use Synthetic

Substitute, Ceramic in 0SRCerclage see RestrictionCerebral aqueduct (Sylvius) use Cerebral VentricleCerebral Embolic Filtration, Dual Filter X2A5312Cerebrum use BrainCervical esophagus use Esophagus, UpperCervical facet joint

use Cervical Vertebral Jointuse Cervical Vertebral Joint, 2 or more

Cervical ganglionuseHead and Neck Sympathetic NerveCervical interspinous ligament use Bursa and Liga-

ment, Head and NeckCervical intertransverse ligamentuseBursa and Liga-

ment, Head and NeckCervical ligamentum flavum use Bursa and Ligament,

Head and NeckCervical lymph node

use Lymphatic, Left Neckuse Lymphatic, Right Neck

Cervicectomysee Excision, Cervix 0UBCsee Resection, Cervix 0UTC

Cervicothoracic facet joint use Cervicothoracic Verte-bral Joint

Cesarean section seeExtraction, Products of Conception10D0

Cesium-131 Collagen ImplantuseRadioactive Element,Cesium-131 Collagen Implant in 00H

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

2 Subterms under main terms may continue to next column or page36

ICD-10-PCS 2019BypassIn

dex

Bypa

ss—

Cha

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devi

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Central Nervous System

and Cranial Nerves

ICD-10-PCS 2019 125

ICD-10-PCS Tables

Central Nervous System and Cranial Nerves 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 7 Dilation 3 Epidural Space, Intracranial X External 4 Radioactive Element,

Cesium-131 Collagen Implant

3 Blood Vessel

8 Division 4 Subdural Space, Intracranial

7 Autologous Tissue Substitute

4 Pleural Cavity

9 Drainage 5 Subarachnoid Space, Intracranial

J Synthetic Substitute 5 Intestine

B Excision 6 Cerebral Ventricle K Nonautologous Tissue Substitute

6 Peritoneal Cavity

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

ple P

age

001–002 Central Nervous System and Cranial Nerves ICD-10-PCS 2019

3 Limited Coverage 4 Noncovered ? Combination Member HAC associated procedure Combination Only DRG Non-OR Non-OR New/Revised in GREEN 128 ICD-10-PCS 2019

001–

002

Cent

ral N

ervo

us S

yste

m a

nd C

rani

al N

erve

s

0 Medical and Surgical0 Central Nervous System and Cranial Nerves 0011 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

6 Cerebral VentricleAqueduct of SylviusCerebral aqueduct (Sylvius)Choroid plexusEpendymaForamen of Monro (intraventricular)Fourth ventricle Interventricular foramen (Monro) Left lateral ventricleRight lateral ventricleThird ventricle

0 Open3 Percutaneous4 Percutaneous Endoscopic

7 Autologous Tissue Substitute

J Synthetic SubstituteK Nonautologous Tissue

Substitute

0 Nasopharynx1 Mastoid Sinus2 Atrium3 Blood Vessel4 Pleural Cavity5 Intestine6 Peritoneal Cavity7 Urinary Tract8 Bone MarrowB Cerebral Cisterns

6 Cerebral VentricleAqueduct of SylviusCerebral aqueduct (Sylvius)Choroid plexusEpendymaForamen of Monro (intraventricular)Fourth ventricle Interventricular foramen (Monro) Left lateral ventricleRight lateral ventricleThird ventricle

0 Open3 Percutaneous4 Percutaneous Endoscopic

Z No Device B Cerebral Cisterns

U Spinal CanalEpidural space, spinalExtradural space, spinalSubarachnoid space, spinalSubdural space, spinalVertebral canal

0 Open3 Percutaneous

7 Autologous Tissue Substitute

J Synthetic SubstituteK Nonautologous Tissue

Substitute

4 Pleural Cavity6 Peritoneal Cavity7 Urinary Tract9 Fallopian Tube

0 Medical and Surgical0 Central Nervous System and Cranial Nerves 0022 Change Definition: Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without

cutting or puncturing the skin or a mucous membraneExplanation: All CHANGE procedures are coded using the approach EXTERNAL

Body PartCharacter 4

ApproachCharacter 5

DeviceCharacter 6

QualifierCharacter 7

0 BrainCerebrumCorpus callosum Encephalon

E Cranial NerveU Spinal Canal

Epidural space, spinalExtradural space, spinalSubarachnoid space, spinalSubdural space, spinalVertebral canal

X External 0 Drainage DeviceY Other Device

Z No Qualifier

Non-OR All body part, approach, device, and qualifier valuesSample

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02H–02H Heart and Great Vessels ICD-10-PCS 2019

3 Limited Coverage 4 Noncovered ? Combination Member HAC associated procedure Combination Only DRG Non-OR Non-OR New/Revised in GREEN172 ICD-10-PCS 2018

02H

–02H

Hea

rt a

nd G

reat

Ves

sels

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 PacemakerY Other Device

Z No Qualifier

A Heart 34 0 Open3 Percutaneous4 Percutaneous Endoscopic

Q Implantable Heart Assist SystemY Other Device

Z No Qualifier

A Heart ? 0 Open3 Percutaneous4 Percutaneous Endoscopic

R Short-term External Heart Assist System

J IntraoperativeS 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 Y Other Device

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, Descending

0 Open 3 Percutaneous 4 Percutaneous Endoscopic

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

Z No Qualifier

X Thoracic Aorta, Ascending/ArchAortic 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]ZDRG Non-OR 02HK32ZDRG Non-OR 02HN32ZNon-OR 02H[4,6,7,L]3[2,3,D]ZNon-OR 02HK3[3,D]ZNon-OR 02H[4,6,7,K,L][3,4]YZNon-OR 02HA[3,4]YZNon-OR 02HN[3,4]YZNon-OR 02HP[0,3,4][0,2,3,Y]ZNon-OR 02HP3DZNon-OR 02H[Q,R][0,3,4][2,3]ZNon-OR 02H[Q,R]3DZNon-OR 02H[Q,R][3,4]YZNon-OR 02H[S,T,V][0,4]3ZNon-OR 02H[S,T,V]3[2,3,D]ZNon-OR 02H[S,T,V][3,4]YZNon-OR 02HW[0,4][0,3]ZNon-OR 02HW3[0,2,3,D]ZNon-OR 02HW[0,3,4]YZNon-OR 02HX[0,3,4][0,3]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,K]33Z when reported with SDx J95.811HAC 02H[6,7]3[J,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA

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

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

T82.6XXA or T82.7XXAHAC 02H[S,T,V][3,4]3Z when reported with SDx J95.8113 02HA0QZ4 02HA[3,4]QZ

See Appendix L for Procedure Combinations? 02H[4,6,7,K,L][0,3,4]KZ? 02H43[J,M]Z? 02HA[0,4]R[S,Z]? 02HA3RS? 02HN[0,3,4][J,K,M]Z

ICD-10-PCS 2019 Upper Arteries Up

per Arteries

ICD-10-PCS 2019 185

Upper Arteries

Head and Neck Arteries

Common carotid H,JVertebral P,Q

External carotid M,N

Internal carotid K,L

Ophthalmic G

Basilar G

Anterior cerebral G Middle cerebral G

Posterior cerebral G

Anterior communicating GPosterior communicating G

Sample

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