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ICD-10 Procedure Coding System

{{short description|Medical classification system used for procedural coding}}

The ICD-10 Procedure Coding System (ICD-10-PCS) is a US system of medical classification used for procedural coding. The Centers for Medicare and Medicaid Services, the agency responsible for maintaining the inpatient procedure code set in the U.S., contracted with 3M Health Information Systems in 1995 to design and then develop a procedure classification system to replace Volume 3 of ICD-9-CM. ICD-9-CM contains a procedure classification; ICD-10-CM does not. ICD-10-PCS is the result. ICD-10-PCS was initially released in 1998. It has been updated annually since that time.{{cite web|title=ICD-10-PCS Reference Manual|url=https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-PCS-and-GEMs.html|format=ZIP|work=Centers for Medicare & Medicaid Services|access-date=25 February 2019}} Despite being named after the WHO's International Classification of Diseases, it is a US-developed standard which is not used outside the United States.{{Cite web |title=ICD-10 FAQ |url=https://www.experian.com/content/dam/marketing/na/healthcare/brochures/icd-10-faq.pdf |access-date=2023-07-12 |website=Experian |quote="The ICD-10-PCS code set is not used internationally"}}

Section structure

Each code consists of seven alphanumeric characters. The first character is the 'section'. The second through seventh characters mean different things in each section. Each character can be any of 34 possible values the ten 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 excluded to avoid confusion with the numbers 0 and 1.{{cite web |author=Richard F. Averill |author2=Robert L. Mullin |author3=Barbara A. Steinbeck |author4=Norbert I. Goldfield |author5=Thelma M. Grant |author6=Rhonda R. Butler | title = Development of the ICD-10 Procedure Coding System (ICD-10-PCS) | publisher = Centers for Medicare and Medicaid Services | url =http://www.cms.hhs.gov/ICD10/Downloads/pcs_final_report2010.pdf | access-date = February 25, 2010 }} There are no decimals in ICD-10-PCS{{cite book |title= Codebusters Coding Connection: A Documentation Guide for Compliant Coding |last= Aalseth |first= Patricia T. |year= 2004 |publisher= Jones & Bartlett Publishers |isbn= 0-7637-2630-3 |page= 27 |url= https://books.google.com/books?id=ZOGemkGhYekC&q=ICD-10-cm+decimal&pg=PA25}}

Of the 72,081 codes in ICD-10-PCS, 62,022 are in the first section, "Medical and surgical".{{Cite web |last=Averill |first=R. F. |last2=Mullin |first2=R. L. |last3=Steinbeck |first3=B. A. |last4=Goldfield |first4=N. I. |last5=Grant |first5=T. M. |last6=Butler |first6=R. R. |title=Development of the ICD-10 Procedure Coding System |url=https://www.cms.gov/Medicare/Coding/ICD10/downloads/pcs_final_report2011.pdf |website=Centers for Medicare & Medicaid Services}}

class="wikitable"
Character 1

! Character 2

! Character 3

! Character 4

! Character 5

! Character 6

! Character 7

0 Medical and Surgical

| Body System
0 Central nervous system; 1 Peripheral nervous system; 2 Heart and Great vessels; 3 Upper arteries; 4 Lower arteries; 5 Upper veins; 6 Lower veins; 7 Lymphatic and Hemic system; 8 Eye; 9 Ear, Nose, Sinus; B Respiratory System; C Mouth and Throat; D Gastrointestinal system; F Hepatobiliary System and Pancreas; G Endocrine system; H Skin and Breast; J Subcutaneous tissue; K Muscles; L Tendons; M Bursae and Ligaments; N Head and Facial bones; P Upper bones; Q Lower bones; R Upper joints; S Lower joints; T Urinary system; U Female reproductive system; V Male reproductive system; W Anatomical regions, General; X Anatomical regions, Upper extremities; Y Anatomical regions, Lower extremities

| Root Operation
see below

| Body Part

| Approach
0 Open; 3 Percutaneous; 4 Percutaneous Endoscopic; 7 Via Natural or Artificial Opening; 8 Via Natural or Artificial Opening Endoscopic; F Via Natural or Artificial Opening Endoscopic with Percutaneous Endoscopic Assistance; X External

| Device

| Qualifier

1 Obstetrics

| {{ICD10PCS|10|1/0}} Pregnancy

| 102 Change; 109 Drainage; 10A Abortion; 10D Extraction; 10E Delivery; 10H Insertion; 10J Inspection; 10P Removal; 10Q Repair; 10S Reposition; 10T Resection; 10Y Transplantation

| Body Part

| Approach

| Device

| Qualifier

2 Placement

| {{ICD10PCS|2W|2/W}} Anatomical Regions; {{ICD10PCS|2Y|2/Y}} Anatomical Orifices

| Root Operation
2?0 Change; 2?1 Compression; 2?2 Dressing; 2?3 Immobilization; 2?4 Packing; 2?5 Removal; 2?6 Traction

| Body Region/Orifice

| Approach

| Device

| Qualifier

3 Administration

| {{ICD10PCS|30|3/0}} Circulatory; {{ICD10PCS|3C|3/C}}Indwelling Device; {{ICD10PCS|3E|3/E}} Physiological Systems and Anatomical Regions

| Root Operation

| Body System/Region

| Approach

| Substance

| Qualifier

4 Measurement and Monitoring

| {{ICD10PCS|4A|4/A}} Physiological Systems; {{ICD10PCS|4B|4/B}} Physiological Devices

| Root Operation

| Body System

| Approach

| Function

| Qualifier

5 Extracorporeal Assistance and Performance

| {{ICD10PCS|5A|5/A}} Physiological Systems

| Root Operation

| Body System

| Duration

| Function

| Qualifier

6 Extracorporeal Therapies

| {{ICD10PCS|6A|6/A}} Physiological Systems

| Root Operation
{{ICD10PCS|6A0|6/A/0}} Atmospheric control; {{ICD10PCS|6A1|6/A/1}} Decompression; {{ICD10PCS|6A2|6/A/2}} Electromagnetic therapy; {{ICD10PCS|6A3|6/A/3}} Hyperthermia; {{ICD10PCS|6A4|6/A/4}} Hypothermia; {{ICD10PCS|6A5|6/A/5}} Pheresis; {{ICD10PCS|6A6|6/A/6}} Phototherapy; {{ICD10PCS|6A7|6/A/7}} Ultrasound therapy; {{ICD10PCS|6A8|6/A/8}} Ultraviolet light therapy; {{ICD10PCS|6A9|6/A/9}} Shock wave therapy

| Body System

| Duration

| Qualifier

| Qualifier

7 Osteopathic

| {{ICD10PCS|7W|7/W}}

| {{ICD10PCS|7W0|7/W/0}}

| Body Region

| Approach

| Method

| Qualifier

8 Other Procedures

| {{ICD10PCS|8C|8/C}} Indwelling Device; {{ICD10PCS|8E|8/E}} Physiological Systems and Anatomical Regions

| Root Operation

| Body Region

| Approach

| Method

| Qualifier

9 Chiropractic

| {{ICD10PCS|9W|9/W}}

| {{ICD10PCS|9WB|9/W/B}}

| Body Region

| Approach

| Method

| Qualifier

B Imaging

| Body System
0 Central Nervous System; 2 Heart; 3 Upper Arteries; 4 Lower Arteries; 5 Veins; 7 Lymphatic System; 8 Eye; 9 Ear, Nose, Mouth and Throat; B Respiratory System; D Gastrointestinal System; F Hepatobiliary System and Pancreas; G Endocrine System; H Skin, Subcutaneous Tissue and Breast; L Connective Tissue; N Skull and Facial Bones; P Non-Axial Upper Bones; Q Non-Axial Lower Bones; R Axial Skeleton, Except Skull and Facial Bones; T Urinary System; U Female Reproductive System; V Male Reproductive System; W Anatomical Regions; Y Fetus and Obstetrical

| Root Type

| Body Part

| Contrast
0=high osmolar contrast; 1=low osmolar contrast; z=other contrast

| Qualifier

| Qualifier

C Nuclear medicine

| Body System
0 Central Nervous System; 2 Heart; 5 Veins; 7 Lymphatic and Hematologic System; 8 Eye; 9 Ear, Nose, Mouth and Throat; B Respiratory System; D Gastrointestinal System; F Hepatobiliary System and Pancreas; G Endocrine System; H Skin, Subcutaneous Tissue and Breast; P Musculoskeletal System; T Urinary System; V Male Reproductive System; W Anatomical Regions

| Root Type

| Body Part

| Radionuclide

| Qualifier

| Qualifier

D Radiation oncology

| Body System
0 Central and Peripheral Nervous System; 7 Lymphatic and Hematologic System; 8 Eye; 9 Ear, Nose, Mouth and Throat; B Respiratory System; D Gastrointestinal System; F Hepatobiliary System and Pancreas; G Endocrine System; H Skin; M Breast; P Musculoskeletal System; T Urinary System; U Female Reproductive System; V Male Reproductive System; W Anatomical Regions

| Root Type

| Body Part

| Modality Qualifier

| Isotope

| Qualifier

F Physical rehabilitation and Diagnostic Audiology

| {{ICD10PCS|F/0}} Rehabilitation; {{ICD10PCS|F/1}} Diagnostic Audiology

| Root Type

| Body System & Region

| Type Qualifier

| Equipment

| Qualifier

G Mental health

| {{ICD10PCS|GZ|G/Z}} None

| Root Type
{{ICD10PCS|GZ1|G/Z/1}} Psychological tests; {{ICD10PCS|GZ2|G/Z/2}} Crisis intervention; {{ICD10PCS|GZ3|G/Z/3}} Medication management; {{ICD10PCS|GZ5|G/Z/5}} Individual psychotherapy; {{ICD10PCS|GZ6|G/Z/6}} Counseling; {{ICD10PCS|GZ7|G/Z/7}} Family psychotherapy; {{ICD10PCS|GZB|G/Z/B}} Electroconvulsive therapy; {{ICD10PCS|GZC|G/Z/C}} Biofeedback; {{ICD10PCS|GZF|G/Z/F}} Hypnosis; {{ICD10PCS|GZG|G/Z/G}} Narcosynthesis; {{ICD10PCS|GZH|G/Z/H}} Group psychotherapy; {{ICD10PCS|GZJ|G/Z/J}} Light therapy

| Type Qualifier

| Qualifier

| Qualifier

| Qualifier

H Substance abuse Treatment

| {{ICD10PCS|HZ|H/Z}} None

| Root Type

| Type Qualifier

| Qualifier

| Qualifier

| Qualifier

{{ICD10PCS|X}} New Technology

|

|

|

|

|

|

=Root operations=

For medical/surgical, these are the root operation codes:

00 alteration; 01 bypass; 02 change; 03 control; 04 creation; 05 destruction; 06 detachment; 07 dilation; 08 division; 09 drainage; 0B excision; 0C extirpation; 0D extraction; 0F fragmentation; 0G fusion; 0H insertion; 0J inspection; 0K map; 0L occlusion; 0M reattachment; 0N release; 0P removal; 0Q repair; 0R replacement; 0S reposition; 0T resection; 0U supplement; 0V restriction; 0W revision; 0X transfer; 0Y transplantation

They can be grouped into several categories:

=Regions=

class="wikitable sortable" style="text-align:center"
scope="col"| Region

! scope="col"| Code

{{rh}}| Head0
{{rh}}| Cervical1
{{rh}}| Thoracic2
{{rh}}| Lumbar3
{{rh}}| Sacrum4
{{rh}}| Pelvis5
{{rh}}| Lower extremities6
{{rh}}| Upper extremities7
{{rh}}| Rib cage8
{{rh}}| Abdomen9

See also

{{Wikisource|ICD-10-PCS (2011)}}

{{Wikidata property |1=P1690}}

References

{{reflist}}

{{Medical classification}}

{{Central nervous system tests and procedures}}

{{Cardiac surgery}}

{{Vascular surgery procedures}}

{{Operations and other procedures of the hemic and lymphatic system}}

{{Eye surgery}}

{{Operations and other procedures on the ear}}

{{Operations and other procedures on the nose, mouth, and pharynx}}

{{Respiratory system surgeries and other procedures}}

{{Digestive system surgical procedures}}

{{Endocrine system operations and other procedures}}

{{Skin and subcutaneous tissue procedures}}

{{Breast procedures}}

{{Muscle/soft tissue procedures}}

{{Bone/joint procedures}}

{{Urologic surgical and other procedures}}

{{Female genital procedures}}

{{Male genital procedures}}

{{Obstetrical procedures}}

{{Medical placement and administration procedures}}

{{Chiropractic}}

{{Medical imaging}}

{{Radiation oncology}}

{{Physical therapy and rehabilitation}}

{{Psychologic and psychiatric evaluation and testing}}

{{Psychotherapy}}

Category:Clinical procedure classification