CMS ICD-10-PCS

ICD-10 Procedure

Coding System

(ICD-10-PCS)

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Development Background

• CMS awarded a contract to 3M Health

Information Systems to develop a new

procedure coding system

• The new system is intended to replace

ICD-9-CM Volume 3 for reporting

inpatient procedures

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Development History

1995 - 1996: First draft of ICD-10-PCS completed

1996 - 1997: Training program developed

Informal testing conducted

ICD-10-PCS revised

1997 - 1998: Independent formal testing conducted

ICD-10-PCS revised

Final draft completed

1998-present ICD-10-PCS updated annually

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Major Development Goals

• Improve accuracy and efficiency of coding

• Reduce training effort

• Improve communication with physicians

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Essential Attributes

• Completeness

– All substantially different procedures have

a unique code

• Expandability

– The structure of the system allows

incorporation of new procedures as

unique codes

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Essential Attributes

Standardized terminology

– Includes definitions of the terminology used.

• While the meaning of specific words can vary in

common usage, ICD-10-PCS defines a single

meaning for each term used in the system.

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Essential Attributes

Multiaxial

– The system has a multi-axial structure.

Each character has the same meaning

within a section and across sections to the

extent possible

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General Principles

• Diagnostic information is not included in

the code description

• A ‘not elsewhere classified’ option is

allowed for new devices and substances

• All substantially different procedures are

defined

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General Principles

Limited NOS Option

A general body part, approach, or root

operation can be used when the level of

specificity required is not available in the

record or cannot otherwise be obtained

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General Principles

Limited NOS Option

• Body Part:

– Example: “Liver” is used when the specific liver lobe is

not identified

• Approach:

– “Open”, “Percutaneous” and “Via Natural or Artificial

Opening”are used when a more specific type of

approach is not documented and cannot otherwise be

determined

• Root Operation:

– “Repair” is used when the procedure documentation

does not support a specific root operation and the

information cannot otherwise be obtained

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Code Structure

• Codes are comprised of seven components.

Each component is called a “character”

– All codes are seven characters long

• Individual units for each character are

represented by a letter or number

– Each unit is called a “value”

• 34 possible values for each character

– Digits 0- 9

– Letters A-H, J-N, P-Z

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System Structure

16 Sections

• Medical and Surgical

• Obstetrics

• Placement

• Administration

• Measurement and

Monitoring

• Extracorporeal Assistance

and Performance

• Extracorporeal Therapies

• Osteopathic

• Other Procedures

• Chiropractic

• Imaging

• Nuclear Medicine

• Radiation Oncology

• Physical Rehabilitation

and Diagnostic Audiology

• Mental Health

• Substance Abuse

Treatment

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ICD-10-PCS Tables

Each table contains four columns and

varying numbers of rows

Column: Specifies the allowable values for

characters 4-7

Row: Specifies the valid combinations of

values

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Example: Table 0DB Excerpt

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ICD-10-PCS Index

• Provides the first three or four values of

the code

• The tables must always be used to obtain

the complete code

• No eponyms are included

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Index Conventions

• Main index term is a root operation, root

procedure type, or common procedure name

Examples: Resection (root operation)

Fluoroscopy (root type)

Prostatectomy (common procedure name)

• Secondary entries are underneath the main term

• PCS Table or code reference as specific as possible

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Index Entry by Body Part

Bypass

Aorta, Thoracic 021W

Aorta, Abdominal 0410

Artery, Axillary, Left 03160

Artery, Axillary, Right 03150

Artery, Brachial, Left 03180

Artery, Brachial, Right 03170

Artery, Common Carotid, Left 031J0

Artery, Common Carotid, Right 031H0

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Medical and Surgical

Section

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Medical and Surgical Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Operation

• 4

th

Character = Body Part

• 5

th

Character = Approach

• 6

th

Character = Device

• 7

th

Character = Qualifier

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Medical and Surgical Section Principles

• The root operation is based on the

objective of the procedure

• If multiple procedures as defined by distinct

objectives are performed, then multiple

codes are assigned

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Medical and Surgical Section

Principles

• Root Operation

– Value is consistent throughout the section

• Approach

– Value is consistent throughout the section

• Body part

– Value is consistent within a specific body

system

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Section Character

Medical and Surgical Section

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Section

(Character 1)

• Defines the general type of procedure

• In the Medical and Surgical Section the first

character is always the number “0”

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Body System Character

Medical and Surgical Section

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Body System

(Character 2)

• Defines the general physiological system on which the

procedure is performed, or anatomical region where the

procedure is performed

• Uses generally accepted anatomical or physiological

categories

• Some traditional categories are subdivided into several

body systems.

– Cardiovascular is subdivided into five body systems:

Heart and Great Vessels Upper Veins

Upper Arteries Lower Veins

Lower Arteries

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Medical and Surgical Section

Body Systems

Central Nervous

Peripheral Nervous

Heart and Great Vessels

Upper Arteries

Lower Arteries

Upper Veins

Lower Veins

Lymphatic and Hemic

Eye

Ear, Nose, Sinus

Respiratory

Mouth and Throat

Gastrointestinal

Hepatobiliary and Pancreas

Endocrine

Skin and Breast

Subcutaneous Tissue and Fascia

Muscles

Tendons

Bursae and Ligaments

Head and Facial Bones

Upper Bones

Lower Bones

Upper Joints

Lower Joints

Urinary

Female Reproductive

Male Reproductive

Anatomical Regions, General

Anatomical Regions, Upper Extremities

Anatomical Regions, Lower Extremities

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Root Operation

Character

Medical and Surgical Section

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Medical and Surgical Section

Root Operation

(Character 3)

• Defines the objective of the procedure

• 31 different root operation values

– Each root operation identifies a precise

and distinct objective

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Medical and Surgical Section

Root Operations

Alteration

Bypass

Change

Control

Creation

Destruction

Detachment

Dilation

Division

Drainage

Release

Removal

Repair

Replacement

Reposition

Resection

Restriction

Revision

Supplement

Transfer

Transplantation

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Excision

Extirpation

Extraction

Fragmentation

Fusion

Insertion

Inspection

Map

Occlusion

Reattachment

Medical and Surgical Section

Root Operation Principles

• The root operation is coded according to

the objective of the procedure actually

performed

– Discontinued or modified procedures coded to

procedure actually performed

• Composite terms (e.g., colonoscopy,

sigmoidectomy) are not root operations

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Medical and Surgical Section

Root Operation Principles

• Combination procedures are coded

separately

– Each procedure with a distinct objective during

an operative episode is coded separately

• The complete or partial redo of a procedure

is coded to the root operation performed

rather than Revision

– Revision is confined to correcting a

malfunctioning or displaced device

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Medical and Surgical Section

Root Operation Groups

• Procedures that take out or eliminate all or a

portion of a body part

• Procedures that involve putting in or on, putting

back, or moving body parts

• Procedures that take out or eliminate solid

matter, fluids, or gases from a body part

• Procedures that only involve examination of body

parts and regions

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Medical and Surgical Section

Root Operation Groups

• Procedures that can be performed only on tubular

body parts

• Procedures that always involve devices

• Procedures involving cutting or separation only

• Procedures involving other repairs

• Procedures with other objectives

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Medical and Surgical Section

Root Operations

Procedures that take out or eliminate

all or a portion of a body part

»Excision

»Resection

» Extraction

» Destruction

»Detachment

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Medical and Surgical Section

Root Operations

Excision

Definition Cutting out or off, without

replacement, a portion of a body part

Explanation The qualifier Diagnostic is used to

identify excision procedures that are

biopsies

Examples Partial nephrectomy

Liver biopsy

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Medical and Surgical Section

Root Operations

Resection

Definition Cutting out or off, without replacement,

all of a body part

Examples Total nephrectomy

Total lobectomy of lung

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Medical and Surgical Section

Root Operations

Extraction

Definition Pulling or stripping out or off all or a portion of

a body part by the use of force

Explanation The qualifier Diagnostic is used to identify

extraction procedures that are biopsies

Examples Dilation and curettage

Vein stripping

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Medical and Surgical Section

Root Operations

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

Examples Fulguration of rectal polyp

Cautery of skin lesion

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Medical and Surgical Section

Root Operations

Detachment

Definition Cutting off all or part of the upper

or lower extremities

Explanation The body part value is the site of

the detachment, with a qualifier if

applicable to further specify the

level where the extremity was

detached

Examples Below knee amputation

Disarticulation of shoulder

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Medical and Surgical Section

Root Operations

Procedures that involve putting in or on, putting

back, or moving living body parts

» Transplantation

» Reattachment

» Reposition

» Transfer

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Medical and Surgical Section

Root Operations

Transplantation

Definition Putting in or on all or a portion of a living body

part taken from another individual or animal to

physically take the place and/or function of all or

a portion of a similar body part

Explanation The native body part may or may not be taken out,

and the transplanted body part may take over all

or a portion of its function

Examples Kidney transplant

Heart transplant

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Medical and Surgical Section

Root Operations

Reattachment

Definition Putting back in or on all or a portion of a

separated body part to its normal location or

other suitable location

Explanation Vascular circulation and nervous pathways

may or may not be reestablished

Examples Reattachment of hand

Reattachment of avulsed kidney

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Medical and Surgical Section

Root Operations

Reposition

Definition Moving to its normal location or other suitable

location all or a portion of a body part

Explanation The body part is moved to a new location from

an abnormal location, or from a normal location

where it is not functioning correctly. The body

part may or may not be cut out or off to be

moved to the new location

Examples Reposition of undescended testicle

Fracture reduction

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Medical and Surgical Section

Root Operations

Transfer

Definition Moving, without taking out, all or a portion of

a body part to another location to take over

the function of all or a portion of a body part

Explanation The body part transferred remains connected to

its vascular and nervous supply

Examples Tendon transfer

Skin pedicle flap transfer

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Medical and Surgical Section

Root Operations

Procedures that take out or eliminate

solid matter, fluids or gases from a body part

» Drainage

» Extirpation

» Fragmentation

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Medical and Surgical Section

Root Operations

Drainage

Definition Taking or letting out fluids and/or

gases from a body part

Explanation The qualifier Diagnostic is used to

identify drainage procedures that are

biopsies

Examples Thoracentesis

Incision and drainage

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Medical and Surgical Section

Root Operations

Extirpation

Definition Taking or cutting out solid matter from a body

part

Explanation The solid matter may be an abnormal byproduct

of a biological function or a foreign body; it may

be imbedded in a body part or in the lumen of a

tubular body part. The solid matter may or may

not have been previously broken into pieces

Examples Thrombectomy

Choledocholithotomy

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Medical and Surgical Section

Root Operations

Fragmentation

Definition Breaking solid matter in a body part into pieces

Explanation Physical force (e.g., manual, ultrasonic) applied

directly or indirectly is used to break the solid

matter into pieces. The solid matter may be an

abnormal byproduct of a biological function or

a foreign body. The pieces of solid matter are

not taken out

Examples Extracorporeal shockwave lithotripsy

Transurethral lithotripsy

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Medical and Surgical Section

Root Operations

Procedures that only involve examination

of body parts and regions

»Inspection

»Map

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Medical and Surgical Section

Root Operations

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

Examples Diagnostic arthroscopy

Exploratory laparotomy

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Medical and Surgical Section

Root Operations

Map

Definition Locating the route of passage of

electrical impulses and/or locating

functional areas in a body part

Explanation Applicable only to the cardiac

conduction mechanism and the central

nervous system

Examples Cardiac mapping

Cortical mapping

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Medical and Surgical Section

Root Operations

Procedures that can be performed only on

tubular body parts

»Bypass

»Dilation

»Occlusion

»Restriction

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Medical and Surgical Section

Root Operations

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

Examples Coronary artery bypass

Colostomy formation

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Medical and Surgical Section

Root Operations

Dilation

Definition Expanding an orifice or the lumen of a tubular

body part

Explanation The orifice can be a natural orifice or an

artificially created orifice. Accomplished by

stretching a tubular body part using intraluminal

pressure or by cutting part of the orifice or wall

of the tubular body part

Examples Percutaneous transluminal angioplasty

Pyloromyotomy

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Medical and Surgical Section

Root Operations

Occlusion

Definition Completely closing the orifice or lumen of a

tubular body part

Explanation The orifice can be a natural orifice or an

artificially created orifice

Example Fallopian tube ligation

Ligation of inferior vena cava

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Medical and Surgical Section

Root Operations

Restriction

Definition Partially closing the orifice or lumen of a

tubular body part

Explanation The orifice can be a natural orifice or an

artificially created orifice

Examples Esophagogastric fundoplication

Cervical cerclage

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Medical and Surgical Section

Root Operations

Procedures that always involve devices

» Insertion

» Replacement

» Supplement

» Removal

» Change

» Revision

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Medical and Surgical Section

Root Operations

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 part

Examples Insertion of radioactive implant

Insertion of central venous catheter

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Medical and Surgical Section

Root Operations

Replacement

Definition Putting in or on biological or synthetic material that

physically takes the place and/or function of all or a portion

of a body part

Explanation The body part may have been taken out or replaced, or may

be taken out, physically eradicated, or rendered

nonfunctional during the Replacement procedure. A

Removal procedure is coded for taking out the device used

in a previous replacement procedure

Examples Total hip replacement, bone graft

Free skin graft

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Medical and Surgical Section

Root Operations

Supplement

Definition Putting in or on biological or synthetic material that

physically reinforces or augments the function of a body part

Explanation The biological material is non-living, or the biological

material is living and from the same individual. The body

part may have been previously replaced. If the body part

has been previously replaced, the Supplement procedure is

performed to physically reinforce and/or augment the

function of the replaced body part

Examples Herniorrhaphy using mesh, free nerve mitral valve ring

annuloplasty, put a new acetabular liner in a previous hip

replacement

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Medical and Surgical Section

Root Operations

Removal

Definition Taking out or off a device from a body part

Explanation If a device is taken out and a similar device put in

without cutting or puncturing the skin or mucous

membrane, the procedure is coded to the root

operation Change. Otherwise, the procedure for

taking out a device is coded to the root operation

Removal

Examples Drainage tube removal

Cardiac pacemaker removal

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Medical and Surgical Section

Root Operations

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 membrane

Explanation All Change procedures are coded using the

approach External

Examples Urinary catheter change

Gastrostomy tube change

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Medical and Surgical Section

Root Operation

Revision

Definition Correcting, to the extent possible, a

malfunctioning or displaced device

Explanation Revision can include correcting a

malfunctioning or displaced device by

taking out or putting in components of the

device such as a screw

Examples Adjustment of position of pacemaker lead

Recementing of hip prosthesis

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Medical and Surgical Section

Root Operations

Procedures involving cutting or separation

only

» Division

»Release

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Medical and Surgical Section

Root Operations

Division

Definition Cutting into a body part without draining

fluids and/or gasses from the body part in

order to separate or transect a body part

Explanation All or a portion of the body part is

separated into two or more portions

Examples Spinal cordotomy, osteotomy

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Medical and Surgical Section

Root Operations

Release

Definition Freeing a body part from an abnormal

physical constraint by cutting or by use of

force

Explanation Some of the restraining tissue may be taken

out but none of the body part is taken out

Examples Adhesiolysis

Carpal tunnel release

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Medical and Surgical Section

Root Operations

Procedures involving other repairs

»Control

»Repair

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Medical and Surgical Section

Root Operations

Control

Definition Stopping, or attempting to stop,

post-procedure bleeding

Explanation The site of the bleeding is coded as an

anatomical region and not to a specific

body part

Examples Control of post-prostatectomy

hemorrhage

Control of post-tonsillectomy hemorrhage

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Medical and Surgical Section

Root Operations

Repair

Definition Restoring, to the extent possible, a body

part to its normal anatomic structure and

function

Explanation Used only when the method to

accomplish the repair is not one of the

other root operations

Examples Colostomy takedown

Suture of laceration

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Medical and Surgical Section

Root Operations

Procedures with other objectives

» Alteration

»Creation

»Fusion

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Medical and Surgical Section

Root Operations

Alteration

Definition Modifying the anatomical

structure of a body part without

affecting the function of the body part

Explanation Principal purpose is to improve

appearance

Examples Face lift

Breast augmentation

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Medical and Surgical Section

Root Operations

Creation

Definition Making a new genital structure that

does not take over the function of a

body part

Explanation Used only for sex change operations

Examples Creation of vagina in a male

Creation of penis in a female

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Medical and Surgical Section

Root Operations

Fusion

Definition Joining together portions of an articular

body part rendering the articular body

part immobile

Explanation The body part is joined together by

fixation device, bone graft, or other

means

Examples Spinal fusion

Ankle arthrodesis

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Body Part Character

Medical and Surgical Section

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Medical and Surgical Section

Body Part Character

(Character 4)

• Defines the specific anatomical site where the

procedure is performed

• 34 possible body part values in each body system

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Medical and Surgical Section

Body Part Values

Hepatobiliary and Pancreas

Liver

Liver, Right Lobe

Liver, Left Lobe

Gallbladder

Hepatic Duct, Right

Hepatic Duct, Left

Cystic Duct

Common Bile Duct

Ampulla of Vater

Pancreatic Duct

Pancreatic Duct, Accessory

Pancreas

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Approach Character

Medical and Surgical Section

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Medical and Surgical Section

Approach

(Character 5)

• Defines the technique used to reach the site of

the procedure

• 7 different approach values

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Medical and Surgical Section

Approach

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Approaches through the skin or mucous

membrane

• Open

• Percutaneous

• Percutaneous Endoscopic

Medical and Surgical Section

Approach Definitions

OPEN

Cutting through the skin or mucous

membrane and any other body layers

necessary to expose the site of the

procedure

Example: Abdominal hysterectomy

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Medical and Surgical Section

Approach Definitions

PERCUTANEOUS

Entry, by puncture or minor incision, of

instrumentation through the skin or mucous

membrane and any other body layers necessary

to reach the site of the procedure

Example: Needle biopsy of liver

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Medical and Surgical Section

Approach Definitions

PERCUTANEOUS ENDOSCOPIC

Entry, by puncture or minor incision, of

instrumentation through the skin or mucous

membrane and any other body layers necessary

to reach and visualize the site of the procedure

Example: Arthroscopy

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Medical and Surgical Section

Approach

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Approaches through an orifice

• Via Natural or Artificial Opening

Endoscopic

• Via Natural or Artificial Opening with

Percutaneous Endoscopic Assistance

Medical and Surgical Section

Approach Definitions

VIA NATURAL OR ARTIFICIAL OPENING

Entry of instrumentation through a natural or

artificial external opening to reach the site of the

procedure

Example: Endotracheal intubation

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Medical and Surgical Section

Approach Definitions

VIA NATURAL OR ARTIFICIAL OPENING

ENDOSCOPIC

Entry of instrumentation through a natural or

artificial external opening to reach and visualize

the site of the procedure

Example: Sigmoidoscopy

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Medical and Surgical Section

Approach Definitions

VIA NATURAL OR ARTIFICIAL OPENING WITH

PERCUTANEOUS ENDOSCOPIC ASSISTANCE

Entry of instrumentation through a natural or

artificial external opening and entry, by puncture or

minor incision, of instrumentation through the skin

or mucous membrane and any other body layers

necessary to aid in the performance of the

procedure

Example: Laparoscopic-assisted vaginal hysterectomy

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Medical and Surgical Section

Approach Definitions

EXTERNAL

Procedures performed directly on the skin or

mucous membrane and procedures performed

indirectly by the application of external force

through the skin or mucous membrane

Example: Closed fracture reduction

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Device Character

Medical and Surgical Section

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Medical and Surgical Section

Device Character

(Character 6)

• The term “device” includes only devices that

remain after the procedure is completed

• Instruments that describe how a procedure is

performed are not specified in the device

character

– Instruments for visualization are specified in the

approach character

• Materials incidental to a procedure such as clips

and sutures are not considered devices

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Medical and Surgical Section

Device Categories

• Biological or synthetic material that takes the place

of all or a portion of a body part (e.g., skin graft,

joint prosthesis)

• Biological or synthetic material that assists or

prevents a physiological function (e.g., urinary

catheter, IUD)

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Medical and Surgical Section

Device Categories

• Therapeutic material that is not absorbed by,

eliminated by, or incorporated into a body part (e.g.,

radioactive implant, orthopedic pins). 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, hearing

device)

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Medical and Surgical Section

Examples of Device Values

• Drainage Device

• Radioactive Element

• Autologous Tissue

Substitute

• Extraluminal Device

• Intraluminal Device

• Synthetic Substitute

• Nonautologous

Tissue Substitute

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Qualifier

Medical and Surgical Section

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Medical and Surgical Section

Qualifier

(Character 7)

• Defines an additional attribute of the procedure

performed, if applicable

• May have a narrow application, to a specific root

operation, body system, or body part

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Medical and Surgical Section

Examples of Qualifiers

• Type of transplant

• Second site for a bypass

• Diagnostic excision (biopsy)

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Obstetrics Section

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Obstetrics Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Operation

• 4

th

Character = Body Part

• 5

th

Character = Approach

• 6

th

Character = Device

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

97

Obstetrics Section

• Includes only procedures performed on the

products of conception

• Operations on the pregnant female are coded

in the Medical and Surgical section (e.g.,

episiotomy)

• Two root operations unique to this section

• Other root operations same as Medical and

Surgical section (e.g., Drainage, Inspection)

RLM.MD

ICD-10-PCS

98

Obstetrics Section

Body System

(Character 2)

Contains a single body system:

– Pregnancy

RLM.MD

ICD-10-PCS

99

Obstetrics Section

Root Operation

(Character 3)

Abortion: Artificially terminating a pregnancy

Delivery: Assisting the passage of the products of

conception from the genital canal

RLM.MD

ICD-10-PCS

100

Obstetrics Section

Body Part

(Character 4)

Contains three different values for body part

– Products of Conception

– Products of Conception, Retained

– Products of Conception, Ectopic

RLM.MD

ICD-10-PCS

101

Obstetrics Section

Body Part

• Products of conception refers to all components

of a pregnancy, including the fetus, embryo,

amnion, umbilical cord and placenta

• There is no differentiation of the products of

conception based on gestational age

RLM.MD

ICD-10-PCS

102

Obstetrics Section

Device

(Character 6)

Some device values unique to this section

Examples:

Laminaria

Abortifacient

Monitoring Electrode

RLM.MD

ICD-10-PCS

103

Obstetrics Section

Qualifier

(Character 7)

Values are dependent on the root

operation, approach, or body part

Examples (root operation dependent):

Method of extraction (e.g., low forceps,

vacuum)

Substance drained (e.g., amniotic fluid, fetal

blood)

RLM.MD

ICD-10-PCS

104

Obstetrics Section Table 10D

RLM.MD

ICD-10-PCS

105

Placement Section

RLM.MD

ICD-10-PCS

106

Placement Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Operation

• 4

th

Character = Body Region/ Orifice

• 5

th

Character = Approach

• 6

th

Character = Device

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

107

Placement Section

Body System

(Character 2)

Contains two body system values:

– Anatomical Regions

– Anatomical Orifices

RLM.MD

ICD-10-PCS

108

Placement Section

Root Operation

(Character 3)

• Five root operations unique to this section

– Compression

– Dressing

– Immobilization

– Packing

– Traction

• Two root operations common to other sections

– Change

– Removal

RLM.MD

ICD-10-PCS

109

Placement Section

Root Operation

(Character 3)

Compression: Putting pressure on a body region

Dressing: Putting material on a body region for

protection

Immobilization: Limiting or preventing motion of

a body region

Packing: Putting material in a body region or

orifice

Traction: Exerting a pulling force on a body

region in a distal direction

RLM.MD

ICD-10-PCS

110

Placement Section

Body Regions/Orifices

(Character 4)

• Two types of values:

– External body regions (e.g., chest wall)

– Natural orifices (e.g., mouth and pharynx)

RLM.MD

ICD-10-PCS

111

Placement Section

Device

(Character 6)

• Specifies the material or device in the placement

procedure (e.g., splint, bandage)

• Includes casts for fractures and dislocations

• Devices in the placement section are off the shelf and do

not require any extensive design, fabrication or fitting

• The placement of devices that require extensive design,

fabrication or fitting are coded in the Rehabilitation

section

RLM.MD

ICD-10-PCS

112

Placement Section

Table 2Y4

RLM.MD

ICD-10-PCS

113

Administration

Section

RLM.MD

ICD-10-PCS

114

Administration Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Physiological System

• 3

rd

Character = Root Operation

• 4

th

Character = Body System/ Region

• 5

th

Character = Approach

• 6

th

Character = Substance

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

115

Administration Section

Body System

(Character 2)

Contains three body system values:

– Physiological Systems and Anatomical Regions

– Circulatory

– Indwelling Device

RLM.MD

ICD-10-PCS

116

Administration Section

Root Operation

(Character 3)

Physiological Systems and Anatomical Regions

Introduction: Putting in a therapeutic, diagnostic,

nutritional, physiological or

prophylactic substance except blood

or blood products

Irrigation: Putting in or on a cleansing

substance

RLM.MD

ICD-10-PCS

117

Administration Section

Root Operation

(Character 3)

Circulatory System

Transfusion: Putting in blood or blood

products

RLM.MD

ICD-10-PCS

118

Administration Section

Root Operation

(Character 3)

Indwelling Device

Irrigation: Putting in or on a cleansing

substance

RLM.MD

ICD-10-PCS

119

Administration Section

Body Part

(Character 4)

• For Introduction, the body part specifies where

the procedure occurs and not necessarily the site

where the substance introduced has an effect

• For Irrigation, the body part specifies the site of

the irrigation

RLM.MD

ICD-10-PCS

120

Administration Section

Approach

(Character 5)

• Approach uses values defined in the Medical and Surgical

section

• The approach value for intradermal, subcutaneous and

intramuscular introductions (i.e., injections) is

percutaneous

• If a catheter is used to introduce a substance into a site

within the circulatory system, the approach value is also

percutaneous

RLM.MD

ICD-10-PCS

121

Administration Section

Substance

(Character 6)

• Substances are specified in broad

categories

• Substance values depend on body part

RLM.MD

ICD-10-PCS

122

Administration Section

Substance

Physiological System & Anatomical Regions

Antineoplastic

Thrombolytic

Anti-infective

Anti-inflammatory

Radioactive Substance

Nutritional Substance

Electrolytic and Water Balance

Substance

Irrigating Substance

Dialysate

Local Anesthetic

Regional Anesthetic

Inhalation Anesthetic

Gas

Contrast Agent

Fertilized Ovum

Sperm

Pigment

Platelet Inhibitor

Destructive Agent

RLM.MD

ICD-10-PCS

123

Examples:

Administration Section

Substance

Circulatory System

Examples:

Serum Albumin

Frozen Plasma

Fresh Plasma

Plasma Cryoprecipitate

Red Blood Cells

Stem Cells, Hematopoietic

RLM.MD

ICD-10-PCS

124

White Cells

Platelets

Globulin

Fibrinogen

Factor IX

Bone Marrow

Administration Section

Qualifier

(Character 7)

• May further specify a substance

• Examples:

– High-dose Interleukin-2

– Liquid Brachytherapy Isotope

– Insulin

RLM.MD

ICD-10-PCS

125

Administration Section

Table 302 Excerpt

RLM.MD

ICD-10-PCS

126

Measurement and

Monitoring Section

RLM.MD

ICD-10-PCS

127

Measurement and Monitoring Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Physiological System

• 3

rd

Character = Root Operation

• 4

th

Character = Body System

• 5

th

Character = Approach

• 6

th

Character = Function

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

128

Measurement and Monitoring

Body System

(Character 2)

Contains a single body system value:

– Physiological Systems

RLM.MD

ICD-10-PCS

129

Measurement and Monitoring

Root Operation

(Character 3)

• Measurement: Determining the level of a

physiological or physical

function at a point in time

• Monitoring: Determining the level of a

physiological or physical

function repetitively over a

period of time

RLM.MD

ICD-10-PCS

130

Measurement and Monitoring

Approach

(Character 5)

Approach contains values also in the

Medical and Surgical section

Examples:

Percutaneous

Via Natural or Artificial Opening

Endoscopic

RLM.MD

ICD-10-PCS

131

Measurement and Monitoring

Function

(Character 6)

Specifies physiological or physical

functions (e.g., nerve conductivity, cardiac

electrical activity, respiratory capacity)

RLM.MD

ICD-10-PCS

132

Measurement and Monitoring

Table 4A1 Excerpt

RLM.MD

ICD-10-PCS

133

Extracorporeal

Assistance and

Performance Section

RLM.MD

ICD-10-PCS

134

Extracorporeal Assistance

and Performance Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Physiological System

• 3

rd

Character = Root Operation

• 4

th

Character = Body System

• 5

th

Character = Duration

• 6

th

Character = Function

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

135

Extracorporeal Assistance

and Performance

Body System

(Character 2)

Contains a single body system value:

• Physiological Systems

RLM.MD

ICD-10-PCS

136

Extracorporeal Assistance

and Performance

Root Operation

(Character 3)

Assistance: Taking over a portion of a physiological

function by extracorporeal means

Performance: Completely taking over a physiological

function by extracorporeal means

Restoration: Returning, or attempting to return, a

physiological function to its normal

state by extracorporeal means

RLM.MD

ICD-10-PCS

137

Extracorporeal Assistance

and Performance

Duration

(Character 5)

• Specifies whether the procedure was a single

occurrence, multiple occurrence, intermittent,

or continuous

• For respiratory ventilation assistance or

performance, the range of hours is specified

(<24 hours, 24-96 hours or >96 hours)

RLM.MD

ICD-10-PCS

138

Extracorporeal Assistance

and Performance

Function

(Character 6)

Specifies the physiological function

assisted or performed (e.g., oxygenation,

ventilation)

RLM.MD

ICD-10-PCS

139

Extracorporeal Assistance

and Performance

Qualifier

(Character 7)

May specify equipment used in the

procedure (e.g., balloon pump)

RLM.MD

ICD-10-PCS

140

Extracorporeal Assistance

and Performance

Table 5A2

RLM.MD

ICD-10-PCS

141

Extracorporeal

Therapies

Section

RLM.MD

ICD-10-PCS

142

Extracorporeal Therapies Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Physiological System

• 3

rd

Character = Root Operation

• 4

th

Character = Body System

• 5

th

Character = Duration

• 6

th

Character = Qualifier

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

143

Extracorporeal Therapies

Body System

(Character 2)

Contains a single body system value:

• Physiological Systems

RLM.MD

ICD-10-PCS

144

Extracorporeal Therapies

Root Operation

(Character 3)

Contains ten root operation values:

Atmospheric Control Pheresis

Decompression Phototherapy

Electromagnetic Therapy Ultrasound Therapy

Hyperthermia Ultraviolet Light

Hypothermia Therapy

Shock Wave Therapy

RLM.MD

ICD-10-PCS

145

Extracorporeal Therapies

Duration

(Character 5)

Specifies whether the procedure was a

single occurrence, multiple occurrence,

or intermittent

RLM.MD

ICD-10-PCS

146

Osteopathic Section

RLM.MD

ICD-10-PCS

147

Osteopathic Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Anatomical Regions

• 3

rd

Character = Root Operation

• 4

th

Character = Body Region

• 5

th

Character = Approach

• 6

th

Character = Method

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

148

Osteopathic Section

Body System

(Character 2)

Contains a single body system value:

– Anatomical Regions

RLM.MD

ICD-10-PCS

149

Osteopathic Section

Root Operation

(Character 3)

Contains a single root operation value

Treatment:

• Manual treatment to eliminate or alleviate

somatic dysfunction and related disorders

RLM.MD

ICD-10-PCS

150

Osteopathic Section

Method

(Character 6)

• Articulatory - Raising

• Fascial Release

• General Mobilization

• High Velocity - Low Amplitude

• Indirect

• Low Velocity- High Amplitude

• Lymphatic Pump

• Muscle Energy - Isometric

• Muscle Energy - Isotonic

• Other Method

RLM.MD

ICD-10-PCS

151

Other Procedures

Section

RLM.MD

ICD-10-PCS

152

Other Procedures Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Physiological Systems/ Anatomical

Regions

• 3

rd

Character = Root Operation

• 4

th

Character = Body Region

• 5

th

Character = Approach

• 6

th

Character = Method

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

153

Other Procedures Section

Root Operation

(Character 3)

Contains a single root operation value

Other Procedures:

– Methodologies which attempt to remediate or cure a

disorder or disease

RLM.MD

ICD-10-PCS

154

Other Procedures Section

Body Region

(Character 4)

Contains physiological system and anatomical region values:

– Nervous System

– Circulatory System

– Head and Neck Region

– Integumentary System and Breast

– Musculoskeletal System

– Female Reproductive System

– Male Reproductive System

– Trunk Region

– Upper Extremity

– Lower Extremity

– None

RLM.MD

ICD-10-PCS

155

Miscellaneous Section

Method

(Character 6)

• Acupuncture

• Therapeutic

Massage

• Collection

RLM.MD

ICD-10-PCS

156

•Computer Assisted Procedure

•Robotic Assisted Procedure

•Near Infrared Spectroscopy

•Other Method

Chiropractic Section

RLM.MD

ICD-10-PCS

157

Chiropractic Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Anatomical Regions

• 3

rd

Character = Root Operation

• 4

th

Character = Body Region

• 5

th

Character = Approach

• 6

th

Character = Method

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

158

Chiropractic Section

Body System

(Character 2)

Contains a single body system value:

– Anatomical Regions

RLM.MD

ICD-10-PCS

159

Chiropractic Section

Root Operation

(Character 3)

Contains a single root operation value

Manipulation:

– Manual procedure that involves a directed thrust to

move a joint past the physiological range of motion,

without exceeding the anatomical limit

RLM.MD

ICD-10-PCS

160

Chiropractic Section

Method

(Character 6)

• Non-Manual

• Indirect Visceral

• Extra-Articular

• Direct Visceral

• Long Lever Specific Contact

• Long and Short Lever Specific Contact

• Mechanically Assisted

• Other Method

RLM.MD

ICD-10-PCS

161

Imaging Section

RLM.MD

ICD-10-PCS

162

Imaging Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Type

• 4

th

Character = Body Part

• 5

th

Character = Contrast

• 6

th

Character = Qualifier

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

163

Imaging Section

• Contains diagnostic radiology procedures

– Nuclear medicine is a separate section

– Radiation Oncology is a separate section

– Interventional Radiology

• The intervention procedure is coded in the Medical

and Surgical section

RLM.MD

ICD-10-PCS

164

Imaging Section

Root Type

(Character 3)

• Plain Radiography

• Fluoroscopy

• CT Scan

• MRI

• Ultrasound

RLM.MD

ICD-10-PCS

165

Imaging Section

Root Type Definitions

(Character 3)

RLM.MD

ICD-10-PCS

166

Imaging Section

Root Type

Plain Radiography

Planar display of an image developed

from the capture of external ionizing

radiation on photographic or

photoconductive plate

RLM.MD

ICD-10-PCS

167

Imaging Section

Root Type

Fluoroscopy

Single plane or bi-plane real time display

of an image developed from the capture

of external ionizing radiation on a

fluorescent screen. The image may also

be stored by either digital or analog

means

RLM.MD

ICD-10-PCS

168

Imaging Section

Root Type

Computerized Tomography

(CT Scan)

Computer-reformatted digital display of

multiplanar images developed from the

capture of multiple exposures of external

ionizing radiation

RLM.MD

ICD-10-PCS

169

Imaging Section

Root Type

Magnetic Resonance Imaging

(MRI)

Computer-reformatted digital display of

multiplanar images developed from the

capture of radio-frequency signals emitted

by nuclei in a body site excited within a

magnetic field

RLM.MD

ICD-10-PCS

170

Imaging Section

Root Type

Ultrasonography

Real time display of images of anatomy or flow

information developed from the capture of

reflected and attenuated high frequency sound

waves

RLM.MD

ICD-10-PCS

171

Imaging Section

Contrast Material

(Character 5)

• Contrast is differentiated by the

concentration of the contrast material

(e.g., high or low osmolar)

RLM.MD

ICD-10-PCS

172

Imaging Section

Qualifier

(Character 6)

• Specifies an imaging procedure without

contrast followed by contrast

RLM.MD

ICD-10-PCS

173

Nuclear Medicine

Section

RLM.MD

ICD-10-PCS

174

Nuclear Medicine Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Type

• 4

th

Character = Body Part

• 5

th

Character = Radionuclide

• 6

th

Character = Qualifier

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

175

Nuclear Medicine Section

Type Definitions

(Character 3)

RLM.MD

ICD-10-PCS

176

Nuclear Medicine

Root Type

Planar Imaging

Introduction of radioactive materials into

the body for a single plane display of

images developed from the capture of

radioactive emissions

RLM.MD

ICD-10-PCS

177

Nuclear Medicine

Root Type

Tomographic (Tomo) Imaging

Introduction of radioactive materials into

the body for three dimensional display of

images developed from the capture of

radioactive emissions

RLM.MD

ICD-10-PCS

178

Nuclear Medicine

Root Type

Positron Emission

Tomographic (PET) Imaging

Introduction of radioactive materials into

the body for three dimensional display of

images developed from the simultaneous

capture, 180 degrees apart, of radioactive

emissions

RLM.MD

ICD-10-PCS

179

Nuclear Medicine

Root Type

Nonimaging Uptake

Introduction of radioactive materials into

the body for measurements of organ

function, from the detection of radioactive

emissions

RLM.MD

ICD-10-PCS

180

Nuclear Medicine

Root Type

Nonimaging Probe

Introduction of radioactive materials into the

body for the study of distribution and fate of

certain substances by the detection of

radioactive emissions; or, alternatively,

measurement of absorption of radioactive

emissions from an external source

RLM.MD

ICD-10-PCS

181

Nuclear Medicine

Root Type

Nonimaging Assay

Introduction of radioactive materials into

the body for the study of body fluids and

blood elements, by the detection of

radioactive emissions

RLM.MD

ICD-10-PCS

182

Nuclear Medicine

Root Type

Systemic Therapy

Introduction of unsealed radioactive

materials into the body for treatment

RLM.MD

ICD-10-PCS

183

Nuclear Medicine Section

Body Part

(Character 4)

• Indicates the body part or region to the

degree of specificity that is usual and

appropriate for the section

• Regional (e.g., lower extremity veins) and

combination body parts (e.g., liver and

spleen) are commonly used

RLM.MD

ICD-10-PCS

184

Nuclear Medicine Section

Radionuclide

(Character 5)

• Character 5 is the source of the radiation

• An “Other Radionuclide” option is included for

new FDA approved radiopharmaceuticals

RLM.MD

ICD-10-PCS

185

Radiation Therapy

Section

RLM.MD

ICD-10-PCS

186

Radiation Therapy Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Type

• 4

th

Character = Treatment Site

• 5

th

Character = Modality Qualifier

• 6

th

Character = Isotope

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

187

Radiation Therapy Section

Root Type

(Character 3)

Classified by the basic mode of radiation

delivery used:

–Beam Radiation

–Brachytherapy

–Stereotactic Radiosurgery

–Other Radiation

RLM.MD

ICD-10-PCS

188

Radiation Therapy Section

Treatment Site

(Character 4)

Specifies the body part that is the target of

the radiation therapy

RLM.MD

ICD-10-PCS

189

Radiation Therapy Section

Modality Qualifier

(Character 5)

Further specifies the type of radiation used:

–photons

–electrons

–heavy particles

–contact radiation

RLM.MD

ICD-10-PCS

190

Radiation Therapy Section

Isotope

(Character 6)

• Specifies the isotope administered in

oncology treatments

RLM.MD

ICD-10-PCS

191

Physical Rehabilitation and

Diagnostic Audiology

Section

RLM.MD

ICD-10-PCS

192

Physical Rehabilitation and

Diagnostic Audiology Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Section Qualifier

• 3

rd

Character = Root Type

• 4

th

Character = Body System and Region

• 5

th

Character = Type Qualifier

• 6

th

Character = Equipment

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

193

Physical Rehabilitation and

Diagnostic Audiology

Root Type

(Character 3)

Treatment:

Use of specific activities or methods to develop, improve

and/or restore the performance of necessary functions,

compensate for dysfunction and /or minimize debilitation

Assessment:

Includes a determination of the patient’s diagnosis when

appropriate, need for treatment, planning for treatment,

periodic assessment and documentation related to these

activities

RLM.MD

ICD-10-PCS

194

Physical Rehabilitation and

Diagnostic Audiology

Root Type

(Character 3)

• Fitting(s):

Design, fabrication, modification, selection and/or

application of splint, orthosis, prosthesis, hearing aids

and/or rehabilitation device

• Caregiver Training:

Educating caregiver with the skills and knowledge used

to interact with and assist the patient

RLM.MD

ICD-10-PCS

195

Physical Rehabilitation and

Diagnostic Audiology

Body System and Region

(Character 4)

• Body Systems

– Neurological System

– Circulatory System

– Respiratory System

– Integumentary System

– Musculoskeletal System

– Genitourinary System

• Body Regions

- Head and Neck

- Upper Back/Upper Extremity

- Lower Back/Lower Extremity

- Whole Body

RLM.MD

ICD-10-PCS

196

Physical Rehabilitation and

Diagnostic Audiology

Type Qualifier

(Character 5)

Specifies the precise test or method

employed

Examples:

Therapeutic exercise treatment

Dressing or transfer assessment

Prosthesis fitting

Transfer caregiver training

RLM.MD

ICD-10-PCS

197

Physical Rehabilitation and

Diagnostic Audiology

Equipment

(Character 6)

• Specific types of equipment are not listed

• General categories of equipment are listed

(e.g., physical agents, mechanical

modalities, assistive/adaptive/supportive

devices)

RLM.MD

ICD-10-PCS

198

Mental Health Section

RLM.MD

ICD-10-PCS

199

Mental Health Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Type

• 4

th

Character = Type Qualifier

• 5

th

Character = Qualifier

• 6

th

Character = Qualifier

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

200

Mental Health Section

Root Type

(Character 3)

Psychological Tests

Crisis Intervention

Medication Management

Individual Psychotherapy

Counseling

Family Psychotherapy

Electroconvulsive Therapy

Biofeedback

Hypnosis

Narcosynthesis

Group Psychotherapy

Light Therapy

RLM.MD

ICD-10-PCS

201

Mental Health Section

Type Qualifier

(Character 4)

• Type qualifier provides additional

specificity

• Not all types have type qualifier

RLM.MD

ICD-10-PCS

202

Mental Health Section

Type Qualifier

(Character 4)

Example:

Psychological Tests

• Developmental

• Personality and Behavioral

• Intellectual and Psychoeducational

• Neuropsychological

• Neurobehavioral and Cognitive Status

RLM.MD

ICD-10-PCS

203

Mental Health Section

Qualifier

(Character 5 - 7 )

Have a value of “Z” None

RLM.MD

ICD-10-PCS

204

Substance Abuse

Treatment Section

RLM.MD

ICD-10-PCS

205

Substance Abuse Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Type

• 4

th

Character = Type Qualifier

• 5

th

Character = Qualifier

• 6

th

Character = Qualifier

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

206

Substance Abuse Treatment

Root Type

(Character 3)

Detoxification Services

Individual Counseling

Group Counseling

Individual Psychotherapy

Family Counseling

Medication Management

Pharmacotherapy

RLM.MD

ICD-10-PCS

207

Substance Abuse Treatment

Type Qualifier

(Character 4)

• Type qualifier provides additional

specificity

• Not all types have type qualifier

RLM.MD

ICD-10-PCS

208

Substance Abuse Treatment

Type Qualifier

(Character 4)

Example:

Pharmacotherapy

• Nicotine Replacement Therapy

• Methadone Maintenance

• LAAM

• Antabuse

• Naltrexone

• Naloxone

• Clonidine

• Bupropion

• Psychiatric Medications

• Other Replacement Medication

RLM.MD

ICD-10-PCS

209

Substance Abuse Treatment

Qualifier

(Character 5 - 7 )

Have a value of “Z” None

RLM.MD

ICD-10-PCS

210

New Technology

Section

RLM.MD

ICD-10-PCS

211

New Technology Section

Character Specification

• 1

st

Character = Section

• 2

nd

Character = Body System

• 3

rd

Character = Root Operation

• 4

th

Character = Body Part

• 5

th

Character = Approach

• 6

th

Character = Device/Substance/Technology

• 7

th

Character = Qualifier

RLM.MD

ICD-10-PCS

212

New Technology Section

Root Operation

(Character 3)

Uses the same root operation values as

their counterparts in other sections of

ICD-10-PCS

– Example: The root operation Introduction has the

same definition as its counterpart in Administration

section of ICD-10-PCS

RLM.MD

ICD-10-PCS

213

New Technology Section

Body Part

(Character 4)

Uses the same body part values that are used in other sections of ICD-10-PCS.

– Example: Central Vein body part value has its counterpart in the

Administration section of ICD-10-PCS

RLM.MD

ICD-10-PCS

214

New Technology Section

Approach

(Character 5)

Uses the same approach values as their closest counterparts in other sections

of ICD-10-PCS.

– External

– Open

– Percutaneous

– Percutaneous Endoscopic

– Via Natural or Artificial Opening

– Via Natural or Artificial Opening Endoscopic

– Via Natural or Artificial Opening With Percutaneous Endoscopic

Assistance

RLM.MD

ICD-10-PCS

215

New Technology Section

Device/Substance/Technology

(Character 6)

• Contains a general description of the key

feature of the new technology

• Example: Ceftazidime-Avibactam Anti-

infective is an example of a new technology

substance

RLM.MD

ICD-10-PCS

216

New Technology Section

Qualifier

(Character 7)

• Used exclusively to indicate the New Technology

Group

• A number or letter that changes each year that

new technology codes are added to the system

• Allows the ICD-10-PCS to “recycle” the values in

the third, fourth, and sixth characters as needed

RLM.MD

ICD-10-PCS

217

ICD-10-PCS Testing

RLM.MD

ICD-10-PCS

218

ICD-10-PCS Testing

• Tested by Clinical Data Abstraction Centers

(CDACs)

– FMAS, Columbia, MD

– DynKePRO, York, PA

• Coded 5,000 records

– Offered feedback on issues found

– Suggested improvements

• Additional comparison test of 100 records

• Additional testing on ambulatory records

RLM.MD

ICD-10-PCS

219

Major Modifications as

a Result of Testing

• Limited Not Otherwise Specified (NOS)

options added

• Number of approaches reduced

• Training manual revised

• Index entries added

RLM.MD

ICD-10-PCS

220

Testing Findings

• More complete than ICD-9-CM, greater

specificity

• Easy to expand the system

• Multi-axial structure makes it easier to

analyze

• Standardized terminology makes it easier to

use once the coder has initial training

RLM.MD

ICD-10-PCS

221

Testing Findings

Initial training time will be a factor since it

differs significantly from ICD-9-CM

– Having all terms defined makes it easier to

teach

– Once basic knowledge is acquired, the coder

does not use the index

RLM.MD

ICD-10-PCS

222