INPATIENT MEDICAL CODING - ICD 10 PCS BASICS - PCS Code

 Inpatient Medical Coding: Codes that are used for representing procedure codes in the Inpatient admission of the patient. Inpatient Medical coding comes under the type of facility coding. In this type of medical coding, we use ICD-10 PCS Codes for representing procedure codes rather than CPT codes. Its Mainly used for Inpatient services to replace the CPT Code. PCS - Procedural Coding System.

ICD-10 PCS Codes: The ICD-10-PCS Tables contains in table format. The tables are arranged in alphanumeric order and organized into separate tables according to the first three characters of the seven-character code. PCS Code Structures are represented with each character.


 

The Seven Characters are listed below : 

1.SECTION: The first character in PCS Codes which includes Medical and Surgical, Obstetrics, Administration, Measurement&Monitoring, Extracorporeal or Systemic Therapies, Assitance and Performance, Placement, Imaging, NuclearMedicines, Radiation Therapy, Osteopathic, Chiropractic, Physical Rehabilitation and Diagnostic Audiology, Mental Health, Substance Abuse Treatment, Other Procedures and finally New Technology.

2.BODY SYSTEM:  The second character of PCS Codes in the Medical and surgical related section which includes the procedure performed in the body part or body systems. For example, if the procedure was done in the Respiratory system it represented with character B. Gastro-Intestinal system procedure done it represented with the character D.

3ROOT OPERATION: The third character of PCS Codes in the Medical and surgical related sections which describes the intent or objective of the procedure done. The Majority of  PCS Codes are reported for the Inpatient Settings are found in the Medical and surgical section of  ICD 10 PCS Codes. There are 31 Root Operations in this third character. This character is important in PCS-ICD 10. For example, Biopsy was done in the lower extremity with cutting and removal of tissue then it leads under Excision Root Operation. If the procedure was done such as paracentesis ( fluid removal in the peritoneal cavity) it leads to Drainage Root operation.

4.BODY PART:  The fourth character of PCS in the Medical and surgical related sections which includes the specific area of the procedure performed. For Example, Laparoscopic Cholecystectomy - 0FT44ZZ - here fourth underline character represented the body part Gall Bladder. Removal of Gall Bladder -Cholecystectomy.

5.APPROACH:  The fifth character of PCS Codes in the Medical and surgical related sections which defines the technique used for a Procedure done. Approach classified under Entry of surgery, Entry of Instrumentation, cutting through the skin, mucous. It is classified into seven different types of approaches. 

  • Open - Abdominal Hysterectomy, Open Appendectomy 
  • Percutaneous - Liposuction, Needle biopsy of the liver
  • Percutaneous Endoscopic - Arthroscopy, Laparoscopic cholecystectomy
  • Via Natural or Artificial Opening -  Endotracheal tube insertion, Foley catheter Placement
  • Via Natural or Artificial Opening Endoscopic - EGD, Colonoscopy 
  • Open with percutaneous Endoscopic Assistance  - Laparoscopic-assisted vaginal Hysterectomy.
  • External - Closed fracture Reduction, Splint placement

6.DEVICE: The sixth character of PCS Codes in the Medical and surgical related sections which is used to specify devices that remain after the procedures are completed. Some of the PCS  code will be having devices are Tunneled Catheter Placement for Dialysis, Implantation of Pacemaker, Defibrillator, Spinal Stimulator and Spinal Generator etc.

                    7.QUALIFIER: The seventh character of PCS Codes in the Medical and Surgical sections which is used to identify the destination site.  

  •     CABG -  02100Z9  the underlined character represents the Qualifier for the LIMA to LAD artery.
  •      Biopsy Denotes the Qualifier characters with Diagnostic in PCS codes are "X".

   

These are the basics of Code structure used in PCS. In my next blog, I will explain a major part of PCS coding and Inpatient Medical Coding.                                                         

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