View source for Medicine: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 [[Medicine:Medical classification|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; [[Medicine:ICD-10-CM|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.<ref>{{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}}</ref> 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.<ref>{{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}}</ref>

==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.<ref Name="pcs_final_report2010">{{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 }}</ref> There are no decimals in ICD-10-PCS<ref Name="Aalseth">{{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}}</ref>

Of the 72,081 codes in ICD-10-PCS, 62,022 are in the first section, "Medical and surgical".<ref name="cms.gov">{{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}}</ref>

{| class="wikitable"
|-
! Character 1
! Character 2
! Character 3
! Character 4
! Character 5
! Character 6
! Character 7
|-
| 0 Medical and Surgical
| Body System<br />0 [[Biology:Central nervous system|Central nervous system]]; 1 [[Biology:Peripheral nervous system|Peripheral nervous system]]; 2 Heart and [[Biology:Great vessels|Great vessels]]; 3 Upper arteries; 4 Lower arteries; 5 Upper veins; 6 Lower veins; 7 Lymphatic and Hemic system; 8 [[Biology:Human eye|Eye]]; 9 [[Medicine:Ear|Ear]], [[Medicine:Human nose|Nose]], Sinus; B Respiratory System; C [[Biology:Mouth|Mouth]] and [[Medicine:Throat|Throat]]; D Gastrointestinal system; F Hepatobiliary System and Pancreas; G Endocrine system; H [[Biology:Skin|Skin]] and Breast;  J [[Biology:Subcutaneous tissue|Subcutaneous tissue]]; K [[Biology:Muscle|Muscle]]s; L Tendons; M Bursae and Ligaments; N [[Medicine:Human head|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<br />see below
| Body Part
| Approach<br />0 Open; 3 [[Medicine:Percutaneous|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 [[Medicine:Obstetrics|Obstetrics]]
| {{ICD10PCS|10|1/0}} [[Medicine:Pregnancy|Pregnancy]]
| 102 Change; 109 [[Medicine:Drainage (medical)|Drainage]]; 10A [[Medicine:Abortion|Abortion]]; 10D Extraction; 10E [[Medicine:Childbirth|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<br />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 [[Medicine:Extracorporeal|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<br />{{ICD10PCS|6A0|6/A/0}} Atmospheric control; {{ICD10PCS|6A1|6/A/1}} [[Medicine:Decompression sickness|Decompression]]; {{ICD10PCS|6A2|6/A/2}} [[Physics:Electromagnetic therapy|Electromagnetic therapy]]; {{ICD10PCS|6A3|6/A/3}} [[Medicine:Hyperthermia|Hyperthermia]]; {{ICD10PCS|6A4|6/A/4}} [[Physics:Hypothermia|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}} [[Medicine:Extracorporeal shockwave therapy|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 [[Unsolved:Chiropractic|Chiropractic]]
| {{ICD10PCS|9W|9/W}}
|  {{ICD10PCS|9WB|9/W/B}}
|  Body Region
|  Approach
|  Method
|  Qualifier
|-
| B [[Medicine:Medical imaging|Imaging]]
|  Body System<br />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<br />0=high osmolar contrast; 1=low osmolar contrast; z=other contrast
|  Qualifier
|  Qualifier
|-
| C [[Medicine:Nuclear medicine|Nuclear medicine]]
|  Body System<br />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<br />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 [[Physics:Audiology|Audiology]]
|  {{ICD10PCS|F/0}} Rehabilitation; {{ICD10PCS|F/1}} Diagnostic Audiology
|  Root Type
|  Body System & Region
|  Type Qualifier
|  Equipment
|  Qualifier
|-
| G [[Social:Mental health|Mental health]]
|  {{ICD10PCS|GZ|G/Z}} None
|  Root Type<br />{{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}} [[Biology:Electroconvulsive therapy|Electroconvulsive therapy]]; {{ICD10PCS|GZC|G/Z/C}} [[Biology:Biofeedback|Biofeedback]]; {{ICD10PCS|GZF|G/Z/F}} [[Unsolved:Hypnosis|Hypnosis]]; {{ICD10PCS|GZG|G/Z/G}} [[Chemistry:Narcosynthesis|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 [[Medicine:Bypass surgery|bypass]]; 02 change; 03 control; 04 creation; 05 destruction; 06 detachment; 07 dilation; 08 division; 09 [[Medicine:Drainage (medical)|drainage]]; 0B [[Medicine:Biopsy#Excisional biopsy|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:<ref name="cms.gov"/>

* take out or eliminate all or a portion of a body part: excision (sigmoid polypectomy), resection (total nephrectomy), extraction (toenail extraction), destruction (rectal polyp fulguration), detachment (below knee amputation). For biopsies, "extraction" is used when force is required (as with endometrial biopsy), and "excision" is used when minimal force is involved (as with [[Medicine:Liver biopsy|liver biopsy]]). See also ectomy.
* involve putting in or on, putting back, or moving living body part: transplantation (heart transplant), reattachment (finger reattachment), reposition (reposition undescended testicle), transfer ([[Medicine:Tendon transfer|tendon transfer]])
* take out or eliminate solid matter, fluids, or gases from a body part: [[Medicine:Drainage (medical)|drainage]] ([[Medicine:Incision and drainage|incision and drainage]]), extirpation (thrombectomy), fragmentation (lithotripsy of gallstones)
* only involve examination of body parts and regions: inspection (diagnostic arthroscopy), map (cardiac mapping)
* involve putting in or on, putting back, or moving living body part: [[Medicine:Bypass surgery|bypass]] (gastrojejunal bypass), dilation (coronary artery dilation), occlusion (fallopian tube ligation), restriction ([[Medicine:Cervical cerclage|cervical cerclage]])
* always involve devices: insertion (pacemaker insertion), replacement (total hip replacement), supplement (herniorrhaphy using mesh), removal (cardiac pacemaker removal), change (drainage tube change), revision (hip prosthesis adjustment)
* involve cutting and separation only: division ([[Medicine:Osteotomy|osteotomy]]), release (peritoneal adhesiolysis)
* involving other repair: control (control of postprostatectomy bleeding), repair (suture of laceration)
* with other objectives: alteration (face lift), creation (artificial vagina creation), fusion ([[Medicine:Spinal fusion|spinal fusion]])

===Regions===
{| class="wikitable sortable" style="text-align:center"
|-
! scope="col"| Region
! scope="col"| Code
|-
|{{rh}}| [[Medicine:Human head|Head]] || 0
|-
|{{rh}}| [[Medicine:Neck|Cervical]] || 1
|-
|{{rh}}| Thoracic || 2
|-
|{{rh}}| [[Biology:Lumbar|Lumbar]] || 3
|-
|{{rh}}| [[Biology:Sacrum|Sacrum]] || 4
|-
|{{rh}}| Pelvis || 5
|-
|{{rh}}| Lower extremities || 6
|-
|{{rh}}| Upper extremities || 7
|-
|{{rh}}| Rib cage || 8
|-
|{{rh}}| [[Biology:Abdomen|Abdomen]] || 9
|}

==See also==
*[[Medicine:ICD-10 Clinical Modification|ICD-10 Clinical Modification]]
{{Wikidata property |1=P1690}}

==References==
{{reflist}}

{{Medical classification}}
{{Cardiac surgery}}
{{Vascular surgery procedures}}
{{Operations and other procedures of the hemic and lymphatic system}}
{{Eye surgery}}
{{Operations and other procedures on the ear}}
{{Respiratory system surgeries and other procedures}}
{{Digestive system surgical procedures}}
{{Muscle/soft tissue procedures}}
{{Bone/joint procedures}}
{{Urologic surgical and other procedures}}
{{Medical placement and administration procedures}}
{{Medical imaging}}
{{Radiation oncology}}
{{Psychotherapy}}

[[Category:Clinical procedure classification]]

{{Sourceattribution|ICD-10 Procedure Coding System}}