Since 1979, reporting procedures for hospital inpatient services has been done using Volume 3 of ICD-9. However, this system not only is outdated, given our current medical knowledge and available technologies, but IC9 Volume 3 is unable to be expanded further to identify specific levels of detail needed to classify procedure codes.
In 1992 the Centers for Medicare and Medicaid Services (CMS) funded a project with 3M Health Information Systems to develop the ICD-10-Procedure Coding System (PCS). ICD-10-PCS is a multi-axial, seven-character, alphanumeric structure providing the specificity needed for thorough inpatient coding. Below are some of the distinct differences:
| ICD-9 VOLUME 3 | ICD-10-PCS |
| 3-4 numbers in length | 7 alphanumeric characters in length |
| Approximately 3,000 codes | Approximately 87,000 codes |
| Based on outdated technology | Reflects current use of medical terminology and devices |
| Lacks detail | Added specificity |
| Lacks laterality | Captures laterality |
| Generic terminology for body parts | Detailed descriptions for body parts |
| Lacks descriptions of methodology and approach for procedures | Provides detailed descriptions of methodology and approach for procedures |
| Lacks precision in defining procedures | Gives precise definition of procedures with detail inclusive of body part, approach, any device used, and additional qualifying information |
All codes in ICD-10-PCS are seven characters in length and each of the seven characters represents an aspect of the procedure. Following is a diagram that illustrates the seven characters of a code from the main section of ICD-10-PCS, the Medical and Surgical section:
| Character | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Definition | Name of Section | Body System | Root Operation | Body Part | Approach | Device | Qualifier |
The following exemplifies the meaning of each character of the code 0LB50ZZ, “Excision of right lower arm and wrist tendon, open”:
| Medical and Surgical | Tendons | Excision | Lower arm and wrist, right | Open | No Device | No Device |
| 0 | L | B | 5 | 0 | Z | Z |
For more ICD-10 articles, please visit our ICD-10 Updates page.
— Compiled by former CIPROMS ICD-10 Coordinator, Angela Hickman, CPC, CEDC, AHIMA-Approved ICD-10 CM/PCS Trainer, AHIMA Ambassador. All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com.
