Jennifer McElroy, CPC

AHIMA Approved ICD-10 CM/PCS Trainer

ICD-10 PCS CODING 101

AGENDA• ICD -10 PCS Guidelines & Conventions

• Medical Surgical

• Body Part vs Body System

• Root Operations

• Approaches

• Device

• Qualifiers

• Case Studies

• The Gray Section

• Case Studies

ICD-10-PCS OVERVIEW• Conventions & Guidelines

• ICD-10-PCS Codes are 7 characters

• The letters I and O are excluded

• Built in room for growth

• Alpha index

• Characters 1 - 3

• Characters 4 – 7

ICD-10-PCS• Body Part Vs. Body System

VS

Mouth & Throat Frenulum linguae

ICD-10-PCS• Body Part Vs. Body System

VS

Aortic Arch Heart and Great Vessels

ICD-10-PCS• Body Part Vs. Body System

VS

Gastrointestinal Sigmoid Colon

ICD-10-PCS MEDICAL SURGICAL• Root Operations

Medical and Surgical Section Root Operations

Alteration Division Inspection Reposition

Bypass Drainage Map Resection

Change Excision Occlusion Restriction

Control Extirpation Reattachment Revision

Creation Extraction Release Supplement

Destruction Fragmentation Removal Transfer

Detachment Fusion Repair Transplantation

Dilation Insertion Replacement

ICD-10-PCS MEDICAL SURGICAL• Root operations

Extraction (D)

ICD-10-PCS MEDICAL SURGICAL• Root operations

Detachment (6)

ICD-10-PCS MEDICAL SURGICAL• Root operations

Transfer (X)

ICD-10-PCS MEDICAL SURGICAL• Root operations

Alteration (0)

ICD-10-PCS MEDICAL SURGICAL• Approaches

• Open (0)

• Percutaneous (3)

• Percutaneous Endoscopic (4)

• Via Natural or Artificial Opening (7)

• Via Natural or Artificial Opening Endoscopic (8)

• Via Natural or Artificial Opening with Percutaneous Endoscopic Assist (F)

• External (X)

ICD-10-PCS MEDICAL SURGICAL• Approaches

Via Natural or Artificial Opening (7)

ICD-10-PCS MEDICAL SURGICAL• Approaches

Via Natural or Artificial opening

with percutaneous Endoscopic

Assistance (F)

ICD-10-PCS MEDICAL SURGICAL• Approaches

Percutaneous (3)

ICD-10-PCS MEDICAL SURGICAL• Approaches

External (X)

ICD-10-PCS MEDICAL SURGICAL• Approaches

Open (0)

ICD-10-PCS MEDICAL SURGICAL• Approaches

Percutaneous Endoscopic (4)

ICD-10-PCS MEDICAL SURGICAL• Approaches

Via Natural or artificial opening

endoscopic

ICD -10 PCS MEDICAL SURGICAL• Devices

• Biological or synthetic material that takes the place of all or a portion of a body part (e.g. skin graft)

• Biological or synthetic material that assists or prevents a physiological function (e.g. urinary catheter, IUD)

• Therapeutic material that is not absorbed by, eliminated by, or incorporated into a body part (e.g. radioactive implant) Therapeutic materials that are considered devices can be removed.

• Mechanical or electronic appliances used to assist, monitor, take the place of, or prevent a physiological function (e.g. diaphragmatic pacemaker, orthopedic pins)

ICD -10 PCS MEDICAL SURGICAL• Qualifier

• Allogeneic (0)

• Syngeneic (1)

• Zooplastic (2)

• Diagnostic (X)

ICD-10-PCS CASE STUDIES• 3.9

• Procedure Performed: Subtotal gastrectomy with Billroth II anastomosis

0DB60ZZ Excision, Stomach Gastrectomy, Partial

0D160ZA – Bypass, Stomach

0DHA0UZ – Insertion of device in, jejunum

ICD-10-PCS CASE STUDIES• 3.13

• Procedure Performed: Left initial inguinal hernia repair with mesh

0YU60JZ – Supplement, inguinal region left, herniorrhaphy with sythetic substitute

ICD-10-PCS CASE STUDIES• 3.38

• Procedure Performed: Exploratory laparotomy, sigmoid colectomy, extended right hemicolectomy, colostomy.

• CODE ONLY PCS codes0DTN0ZZ – Resection, Colon, Sigmoid

0DTF0ZZ – Resection, Intestine, Large Right Hemicolectomy

0DBL0ZZ – Excision, Colon, Transverse

0D1M0Z4 – Bypass, Colon Descending Colostomy

ICD-10-PCS - OBSTETRICS• Root Operations (2 added)

• Abortion (A)

• Delivery (E)

• Body Parts

• Products of Conception

• Products of Conception, retained

• Products of Conception, ectopic

ICD-10 PCS - PLACEMENT• Root Operations

• Compression (1)

• Dressing (2)

• Immobilization (3)

• Packing (4)

• Traction(6)

ICD-10 PCS - ADMINISTRATION• Body Systems

• Circulatory system

• Indwelling Device

• Physiological Systems and Anatomical Regions

• Root operations

• Introduction

• Irrigation

• Transfusion

ICD-10 PCS – MEASUREMENT & MONITORING

• Measurement – Determining the level of a physiological or physical function at a point in time.

• Monitoring – Determining the level of physiological or physical function repetitively over a period of time.

ICD-10 PCS – EXTRACORPEAL• Extracorpeal Assistance and Performance

• Root Operations

• Assistance

• Performance

• Restoration

ICD-10 PCS – EXTRACORPEAL• Extracorpeal Therapies

• Root Operations

• Atmospheric Control

• Decompression

• Electromagnetic Therapy

• Hyperthermia

• Hypothermia

• Pheresis

• Ultrsound Therapy

• Ultraviolet Light Therapy

• Shock wave Therapy

ICD-10 PCS OSTEOPATHIC, OTHER & CHIROPRACTIC• Osteopathic Section

• Root Operation – Treatment

• Other Procedures Section

• Root Operation – Other procedures

• Chiropractic

• Root Operation - Manipulation

ICD-10 ANCILLARY SECTION• Imaging (B)

• Nuclear Medicine (C)

• Radiation Oncology (D)

• Physical Rehabilitation and Diagnostic Audiology (F)

• Mental Health (G)

• Substance Abuse Treatment (H)

ICD-10-PCS CASE STUDIES• 3.41

• Procedure Performed: Transvaginal abortion using vacuum aspiration technique.

10A07Z6 – Abortion, Vacuum

ICD-10-PCS CASE STUDIES• 3.43

• Procedure Performed: Fetal spinal tap, percutaneous

10903ZA – Drainage, Products of Conception, Fetal cerebrospinal fluid

ICD-10-PCS CASE STUDIES• 3.79

• Procedure Performed: Alcohol detoxification treatment

HZ2ZZZZ – Dextoxification Services for substance abuse

REFERENCES• ICD-10-PCS Coder Training Manual, 2013 Edition (AHIMA Press)

• ICD-10-PCS Official Guidelines for Coding and Reporting