ICD-10 Procedure Coding System

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.[1] 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.[2]

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.[3] There are no decimals in ICD-10-PCS[4]

Of the 72,081 codes in ICD-10-PCS, 62,022 are in the first section, "Medical and surgical".[5]

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 10 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 2W Anatomical Regions; 2Y 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 30 Circulatory; 3CIndwelling Device; 3E Physiological Systems and Anatomical Regions Root Operation Body System/Region Approach Substance Qualifier
4 Measurement and Monitoring 4A Physiological Systems; 4B Physiological Devices Root Operation Body System Approach Function Qualifier
5 Extracorporeal Assistance and Performance 5A Physiological Systems Root Operation Body System Duration Function Qualifier
6 Extracorporeal Therapies 6A Physiological Systems Root Operation
6A0 Atmospheric control; 6A1 Decompression; 6A2 Electromagnetic therapy; 6A3 Hyperthermia; 6A4 Hypothermia; 6A5 Pheresis; 6A6 Phototherapy; 6A7 Ultrasound therapy; 6A8 Ultraviolet light therapy; 6A9 Shock wave therapy
Body System Duration Qualifier Qualifier
7 Osteopathic 7W 7W0 Body Region Approach Method Qualifier
8 Other Procedures 8C Indwelling Device; 8E Physiological Systems and Anatomical Regions Root Operation Body Region Approach Method Qualifier
9 Chiropractic 9W 9WB 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 F/0 Rehabilitation; F/1 Diagnostic Audiology Root Type Body System & Region Type Qualifier Equipment Qualifier
G Mental health GZ None Root Type
GZ1 Psychological tests; GZ2 Crisis intervention; GZ3 Medication management; GZ5 Individual psychotherapy; GZ6 Counseling; GZ7 Family psychotherapy; GZB Electroconvulsive therapy; GZC Biofeedback; GZF Hypnosis; GZG Narcosynthesis; GZH Group psychotherapy; GZJ Light therapy
Type Qualifier Qualifier Qualifier Qualifier
H Substance abuse Treatment HZ None Root Type Type Qualifier Qualifier Qualifier Qualifier
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:[5]

Regions

Region Code
Head 0
Cervical 1
Thoracic 2
Lumbar 3
Sacrum 4
Pelvis 5
Lower extremities 6
Upper extremities 7
Rib cage 8
Abdomen 9

See also

Wikisource has original text related to this article:
ICD-10-PCS (2011)
Wikidata has the property:
  • ICD-10-PCS (P1690) (see uses)

References

  1. ^ "ICD-10-PCS Reference Manual" (ZIP). Centers for Medicare & Medicaid Services. Retrieved 25 February 2019.
  2. ^ "ICD-10 FAQ" (PDF). Experian. Retrieved 2023-07-12.
  3. ^ Richard F. Averill; Robert L. Mullin; Barbara A. Steinbeck; Norbert I. Goldfield; Thelma M. Grant; Rhonda R. Butler. "Development of the ICD-10 Procedure Coding System (ICD-10-PCS)" (PDF). Centers for Medicare and Medicaid Services. Retrieved February 25, 2010.
  4. ^ Aalseth, Patricia T. (2004). Codebusters Coding Connection: A Documentation Guide for Compliant Coding. Jones & Bartlett Publishers. p. 27. ISBN 0-7637-2630-3.
  5. ^ a b Averill, R. F.; Mullin, R. L.; Steinbeck, B. A.; Goldfield, N. I.; Grant, T. M.; Butler, R. R. "Development of the ICD-10 Procedure Coding System" (PDF). Centers for Medicare & Medicaid Services.
  • v
  • t
  • e
Topographical codes
Diagnostic codes
general:
specialized:
Procedural codesPharmaceutical codesOutcomes codes
  • v
  • t
  • e
Tests and procedures involving the central nervous system
Skull
Brain
thalamus and globus pallidus
ventricular system
cerebrum
Other
Meninges
Spinal cord and spinal canal
Imaging
Diagnostic
Clinical prediction rules
  • v
  • t
  • e
Tests and procedures involving the heart
Surgery
Heart valves
and septa
production of septal defect in heart
enlargement of existing septal defect
Atrial septostomy
Balloon septostomy
creation of septal defect in heart
Blalock–Hanlon procedure
shunt from heart chamber to blood vessel
atrium to pulmonary artery
Fontan procedure
left ventricle to aorta
Rastelli procedure
right ventricle to pulmonary artery
Sano shunt
compound procedures
for transposition of the great vessels
Arterial switch operation
Mustard procedure
Senning procedure
for univentricular defect
Norwood procedure
Kawashima procedure
shunt from blood vessel to blood vessel
systemic circulation to pulmonary artery shunt
Blalock–Taussig shunt
SVC to the right PA
Glenn procedure
Cardiac vessels
Other
Tests
Function tests
Pacing
Category
  • v
  • t
  • e
Vascular and
Endovascular surgery
Arterial disease
Venous disease
Arterial and venous access
Aortic aneurysm / dissection:
Other
Medical imaging
Angiography
Venography
Ultrasound
Other diagnostic
  • v
  • t
  • e
Procedures relating to the haematopoetic and lymphatic systems
Bone marrow
Thymus
Spleen
Lymph nodes
Tonsils
  • see Template:Procedures on the mouth and pharynx
Imaging
  • v
  • t
  • e
Tests and procedures involving the eyes
Adnexa
Eyelids
Lacrimal system
Globe
Refractive
surgery
Cataract
surgery
Retinal
surgery
Glaucoma
surgery
Transplantation
Other
Extraocular
muscles
Medical
imaging
Eye
examination
Radiation
therapy
History
  • Couching
  • Cryoextraction
  • v
  • t
  • e
Tests and procedures on the ear
Outer ear
Middle ear
Inner ear
Tests
  • v
  • t
  • e
Procedures relating to the mouth and pharynx
Mouth
lip:
tongue:
teeth:
  • see Template:Endodontology
gingiva:
  • see Template:Periodontology
Oropharynx
palate:
tonsil:
uvula:
  • v
  • t
  • e
Tests and procedures involving the respiratory system
Surgery
Upper RT
Lower RT
Chest wall, pleura,
mediastinum,
and diaphragm
Tests
Medical imaging
Clinical prediction rule
Lung function test
Cytology
Other
Other procedures
Oxygen therapy
Respiratory therapy
  • v
  • t
  • e
Tests and procedures involving the human digestive system
Digestive tract
Upper GI tract
SGs / Esophagus
Stomach
Medical imaging
Lower GI tract
Small bowel
Large bowel
Rectum
Anal canal
Medical imaging
Stool tests
Accessory
Liver
Gallbladder, bile duct
Pancreas
Abdominopelvic
Peritoneum
Hernia
Other
Clinical prediction rules
  • v
  • t
  • e
Test and procedures involving the endocrine system
Pancreas
Pituitary
Thyroid
Adrenal gland
Pineal gland
  • v
  • t
  • e
Tests and procedures on the skin and subcutaneous tissue
Skin
Hair
  • v
  • t
  • e
Tests and procedures involving the breast
Breast surgery
Breast imaging
Other
  • v
  • t
  • e
Tests and procedures on muscle and soft tissue
Muscle
Tendon
Fascia
Bursa
Other
  • v
  • t
  • e
Procedures involving bones and joints
Bones
Face
Spine
Arm
Leg
General
Cartilage
Joints
Spine
Arm
Leg
General
  • v
  • t
  • e
Tests and procedures involving the urinary system
Kidney
Ureter
Bladder
Urethra
General
Imaging
Other
  • v
  • t
  • e
Tests and procedures involving the female reproductive system
Ovaries
Fallopian tubes
Uterus
General:
Uterine cavity:
Endometrium:
Myometrium:
Cervix:
Vagina
Vulva
Medical imaging
  • v
  • t
  • e
Tests and procedures involving the male reproductive system
Prostate
Seminal vesicles
Vas deferens
Testes
Penis
Other tests
  • v
  • t
  • e
Tests and procedures relating to pregnancy and childbirth
Maternal tests
Fetal tests
Imaging
Sampling
Other
Interventions
Delivery
Vaginal delivery
Induction
Dystocia management
Third stage of labor
Caesarean section
Postpartum bleeding
  • v
  • t
  • e
subspecialties
General procedures
  • v
  • t
  • e
Chiropractic
Techniques
Education
Accrediting bodies
International organizations
People
  • Category
  • v
  • t
  • e
X-ray/
radiography
2D
CT scan
Techniques:
Targets
Other
MRI
Ultrasound
Radionuclide
2D/scintigraphy
Full body:
3D/ECT
SPECT (gamma ray):
PET (positron):
Optical/Laser
Thermography
Target conditions
  • Category
  • v
  • t
  • e
Specific
therapies
Teletherapy1
by photon
by electron
by hadron
Brachytherapy2
Unsealed source
radiotherapy3
Other
Conditions
Features and
equipment
  • 1 Also known as external-beam radiotherapy.   
  • 2 Also known as sealed-source radiation therapy.   
  • 3 Also known as systemic radioisotope therapy.
  • v
  • t
  • e
Physical rehabilitation disciplines
Education
Intervention techniques
Professional associations
and regulatory agencies
Other related articles
  • v
  • t
  • e
Psychological and psychiatric evaluation and testing
Intelligence tests
Personality tests
Projective tests
Neuropsychological test
Other tests
  • v
  • t
  • e
Schools
Psychodynamic
Cognitive and
behavioral
Humanistic
Other
Integrative
Approaches
Research
Techniques
Behaviour therapy
Other individual therapy
Group psychotherapy
People
Associations