1. Jennifer McElroy, CPC AHIMA Approved ICD-10 CM/PCS Trainer
ICD-10 PCS Coding 101
Jennifer McElroy, CPC
AHIMA Approved ICD-10 CM/PCS Trainer

2. Agenda ICD -10 PCS Guidelines & Conventions Medical Surgical
Body Part vs Body System
Root Operations
Approaches
Device
Qualifiers
Case Studies
The Gray Section

3. 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

4. ICD-10-PCS VS Body Part Vs. Body System Mouth & Throat
Frenulum linguae

5. ICD-10-PCS VS Body Part Vs. Body System Aortic Arch
Heart and Great Vessels

6. ICD-10-PCS
Body Part Vs. Body System VS
Gastrointestinal
Sigmoid Colon

7. 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

8. ICD-10-PCS Medical Surgical
Root operations
Extraction (D)

9. ICD-10-PCS Medical Surgical
Root operations
Detachment (6)

10. ICD-10-PCS Medical Surgical
Root operations
Transfer (X)

11. ICD-10-PCS Medical Surgical
Root operations
Alteration (0)

12. 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)

13. ICD-10-PCS Medical Surgical
Approaches
Via Natural or Artificial Opening (7)

14. ICD-10-PCS Medical Surgical
Approaches
Via Natural or Artificial opening with percutaneous Endoscopic Assistance (F)

15. ICD-10-PCS Medical Surgical
Approaches
Percutaneous (3)

16. ICD-10-PCS Medical Surgical
Approaches
External (X)

17. ICD-10-PCS Medical Surgical
Approaches
Open (0)

18. ICD-10-PCS Medical Surgical
Approaches
Percutaneous Endoscopic (4)

19. ICD-10-PCS Medical Surgical
Approaches
Via Natural or artificial opening endoscopic

20. 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)

21. ICD -10 PCS Medical surgical
Qualifier
Allogeneic (0)
Syngeneic (1)
Zooplastic (2)
Diagnostic (X)

22. 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

23. 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

24. ICD-10-PCS Case studies
3.38
Procedure Performed: Exploratory laparotomy, sigmoid colectomy, extended right hemicolectomy, colostomy.
CODE ONLY PCS codes
0DTN0ZZ – Resection, Colon, Sigmoid
0DTF0ZZ – Resection, Intestine, Large Right Hemicolectomy
0DBL0ZZ – Excision, Colon, Transverse
0D1M0Z4 – Bypass, Colon Descending Colostomy

25. 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

26. ICD-10 PCS - Placement Root Operations Compression (1) Dressing (2)
Immobilization (3)
Packing (4)
Traction(6)

27. ICD-10 PCS - Administration
Body Systems
Circulatory system
Indwelling Device
Physiological Systems and Anatomical Regions
Root operations
Introduction
Irrigation
Transfusion

28. 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.

29. ICD-10 PCS – Extracorpeal
Extracorpeal Assistance and Performance
Root Operations
Assistance
Performance
Restoration

30. ICD-10 PCS – Extracorpeal
Extracorpeal Therapies
Root Operations
Atmospheric Control
Decompression
Electromagnetic Therapy
Hyperthermia
Hypothermia
Pheresis
Ultrsound Therapy
Ultraviolet Light Therapy
Shock wave Therapy

31. ICD-10 PCS Osteopathic, other & Chiropractic
Osteopathic Section
Root Operation – Treatment
Other Procedures Section
Root Operation – Other procedures
Chiropractic
Root Operation - Manipulation
Osteopathic
Other Procedures
Chiropractic – Approach is always external……

32. 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)
We are at the end finally!
Imaging – Chest xrays AP/PA and lateral views
Nuclear Med – PET Scans
Radiation Oncology – Electron radiation
Physical Rehab and Diagnostic Audiology – Wound care treatment, Brace fittings
Mental Health – Crisis interventions, psychotherapy
Substance Abuse – Drug Addiction, Just like it sounds

33. ICD-10-PCS Case studies
3.41
Procedure Performed: Transvaginal abortion using vacuum aspiration technique.
10A07Z6 – Abortion, Vacuum
If you have your book turn to page 194.
I will give you a couple mins to read and answer the case.

34. ICD-10-PCS Case studies
3.43
Procedure Performed: Fetal spinal tap, percutaneous
10903ZA – Drainage, Products of Conception, Fetal cerebrospinal fluid

35. ICD-10-PCS Case studies
3.79
Procedure Performed: Alcohol detoxification treatment
HZ2ZZZZ – Dextoxification Services for substance abuse

36. REferences
ICD-10-PCS Coder Training Manual, 2013 Edition (AHIMA Press)
ICD-10-PCS Official Guidelines for Coding and Reporting