Guest post: Using the ICD-10-PCS Manual
Editor’s note: This is part one of a series reviewing rules for ICD-10-PCS code assignment. To gain the most from this series, have an ICD-10-PCS manual in front of you and flip to the various sections for each step to see how the process works.
by Joe Rivet, JD, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO
Similar to diagnosis coding, start in the Alphabetic Index using a main term when reporting in ICD-10-PCS. A main term is most commonly one of three types of terms:
- A body part, such as “lung”
- A common procedure term, such as “appendectomy”
- A root operation, such as “Excision”
Always start broadly and narrow your way down. Each indention within the Index further subdivides the procedure to greater specificity. The indentations within the ICD-10-PCS Index function just like the diagnosis portion of ICD-10-CM.
When a main term is the root operation, like Excision, the entry within the Index is followed by subterms, which are indented for specific body parts where the operation was performed.
When the main term is a common procedure, the Index provides lists of body parts of where the procedure could be performed. When the main term is an anatomical site, body parts are followed under the anatomical site main term listing specific body parts.
You may also use one of the tables in the ICD-10-PCS manual to select a code. As with any code selection, never code directly from the Index. Make sure to look up the code to ensure you are reporting the procedure correctly.
Editor’s note: Rivet is a partner with the American Regulatory Compliance Society in Grand Haven, Michigan. His experience includes conducting fraud, waste, and abuse audits across a wide variety of services and provider settings. He is a national speaker and has published two books along with numerous articles. Opinions expressed are that of the author and do not necessarily represent HCPro, ACDIS, or any of its subsidiaries. Want to write for the ACDIS Blog? Contact ACDIS Associate Editor Carolyn Riel today!