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 However, this system not only is outdated, given our current medical knowledge and available technologies, but IC9 Volume 3 is unable to be expanded further to identify specific levels of detail needed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|Based on outdated technology||Reflects current use of medical terminology and devices|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:
|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|
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 firstname.lastname@example.org.