ICD-10-PCS Coding Study Guide: Chapter 7 Overview

ICD-10-CM/PCS Coding I – Study Guide Chapter 7 – Introduction to the ICD-10-PCS Classification Coding Handbook 2022 Introduction 1. Does ICD-10-PCS include eponyms? In the ICD-10-PCS (International Classification of Diseases, Tenth Revision, Procedure Coding System), you won’t find any eponyms— words derived from the name of a real, fictional, mythical, or spurious character or person. So, when a physician uses terms like “Whipple procedure,” it’s essential to understand that they are referring to a pancreaticoduodenectomy. Similarly, an Abbott-Fisher-Lucas procedure involves a two-stage technique for hip fusion in the absence of a femoral head, failed femoral prosthesis, or infected trochanteric mold arthroplasty. If you encounter terms like Smead-Jones technique, which is a running closure technique for approximating abdominal fascia, rectus muscles, and anterior peritoneum, it’s crucial to clarify their meaning with the physicians. While physicians are not required to change their terminology for documenting procedures in ICD-10-PCS, understanding the actual procedures will help you navigate the coding process Development of ICD-10-PCS 1. ICD-10-PCS consists of sections. The ICD-10-PCS (International Classification of Diseases, Tenth Revision, Procedure Coding System) is a comprehensive system used for coding inpatient procedures. It was developed for the Centers for Medicare and Medicaid Services (CMS). Let’s dive into the details: 1. Overview: The ICD-10-PCS manual begins with an overview that provides a general introduction to the system. It covers the history of its development, the code structure, organization, and key characteristics. The overview is divided into three parts: basic information, structure, and applications1.

2. Sections: The ICD-10-PCS is divided into 17 sections, each serving a specific purpose. Here are some of the notable sections: w Medical and Surgical Section (Section 0): This section includes procedures related to medical and surgical interventions. It covers a wide range of operations, such as excisions, repairs, and transplants12. w Obstetrics Section (Section 1): This section focuses on procedures related to pregnancy, childbirth, and postpartum care1. w Imaging Section: This section deals with procedures related to diagnostic imaging, including radiography, MRI, and CT scans. It helps capture details about imaging-guided interventions2. w Other sections cover areas like administration, measurement and monitoring, extracorporeal assistance, and more1. 3. Code Structure: A complete ICD-10-PCS code consists of seven characters. Each character represents specific information about the procedure performed. The meaning of these characters varies across the different sections. The first character of the code always specifies the section23. 4. Tables and Definitions: Within each section, tables provide detailed information. The upper part of each table describes the first three characters of the procedure code, while the lower part specifies valid combinations of values for characters 4 to 74. 2. ICD-10-PCS consists of codes. The ICD-10-PCS (International Classification of Diseases, 10th Revision, Procedure Coding System) is a classification system used for coding and reporting medical procedures performed in hospital inpatient settings. Here are some key points about ICD-10-PCS codes: 1. Structure of ICD-10-PCS Codes: w ICD-10-PCS codes consist of seven characters.

w Each character serves as an axis of classification that provides specific information about the procedure performed. w Within a defined code range, a character specifies the same type of information related to that axis of classification12. 2. Cooperating Parties and Guidelines: w The guidelines for using ICD-10-PCS are developed by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). w These guidelines are approved by the four organizations that make up the Cooperating Parties for ICD-10-PCS: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. w Adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA) for assigning ICD-10-PCS procedure codes in hospital inpatient healthcare settings1. 3. Components of ICD-10-PCS Codes: w The seven characters in an ICD-10-PCS code represent different aspects of the procedure: w Section: The first character indicates the general category or section of the procedure. w Body System: The second character specifies the body system involved. w Root Operation: The third character describes the main action or objective of the procedure. w Body Part: The fourth through seventh characters identify the specific body part or anatomical site. w Approach, Device, and other details may also be included in subsequent characters3. Remember that accurate documentation and collaboration between healthcare providers and coders are essential for precise code assignment and reporting of diagnoses and procedures. 🏥🏥

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