1. Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

2. Introduction to ICD-10-PCS
CHAPTER 27
Introduction to ICD-10-PCS

3. ICD-10-PCS
ICD-10-PCS, or the International Classification of Diseases, Tenth Revision, Procedure Coding System, will replace Volume 3 of ICD-9-CM.
Codes from ICD10-PCS will be used to report inpatient procedures.

4. ICD-10-PCS Code Structure
ICD-10-PCS has a seven-character alphanumeric code structure.
Each character contains up to 34 possible values.
The 10 digits 0-9 and the 24 letters A-H, J-N and P-Z may be used in each character. The letters O and I are not used.

5. Constructing a Code
A code is derived by choosing a specific value for each of the seven characters.
The values typically specify the section, body system, root operation, body part, approach, device, and qualifier.
The same letter or number placed in a different position in the code has different meaning.

6. First Character The first character always specifies the section.
There are 16 sections in ICD-10-PCS.

7. Table Sections and Identifiers
ICD-10-PCS has the following sections and
identifiers:
Medical and surgical—0
Obstetrics—1
Placement—2
Administration—3
Measurement and monitoring—4
Extracorporeal assistance and performance—5

8. Table Sections and Identifiers (cont.)
Extracorporeal therapies—6
Osteopathic—7
Other procedures—8
Chiropractic—9
Imaging—B
Nuclear medicine—C
Radiation oncology—D

9. Table Sections and Identifiers (cont.)
Physical rehabilitation and diagnostic audiology—F
Mental health—G
Substance abuse treatment—H

10. Second through Seventh Characters
The second through seventh characters have the same meaning within each section but may have a different meaning in other sections.
To identify the specific meanings, the tables must be referenced.

11. Locating a Code in the ICD-10-PCS Manual
Codes may be found in the index by referencing the general type of procedure.
The index will specify a minimum of three characters to direct the coder to a specific table.

12. ICD-10-PCS Manual (cont.)
Based on the three values of the code, the corresponding table can be located.
The tables and characters are arranged first by number and then by letter for each character.
The Tables section must be used to construct a complete and valid code.

13. Example of Procedure Code Selection
Assume that you are coding the following:
Right total mastectomy, open approach
Reference the index under the term mastectomy.
Here you will find two subterms: excision and resection. You are coding a resection.
Now locate the table 0HT.
Select the appropriate 4th to 7th digits.
The correct code is 0HTT0ZZ.

14. Key Points to Remember
Diagnostic information is not included in the descriptions of the procedures found in ICD-10-PCS.
ICD-10-PCS contains seven alphanumeric characters.

15. Additional Points
Sections are identified with either a letter or a number.
Coding of procedures starts with referencing the Index.
The Index contains a list of three to four characters.

16. Final Points
After referencing the Index, the coder needs to reference the Tables.
The Tables define all the characters, and the final code is built from the information within the Tables.

17. Coding Practice Select the code for the following:
Open Excision of median nerve

18. Coding Practice Solution
Main term to reference in index:
Excision
Modifying term:
Nerve, then Median
Code Assignment:
01B50ZZ