ICD-10-PCS

Sharme Brodie, RN, CCDS , highlights guidance on ICD-10-PCS root operations and seventh characters for ICD-10-CM from the latest issue of Coding Clinic .

Complete capture of procedure codes in ICD-9-CM helps to ensure accurate translation to ICD-10-PCS. Donna M. Smith and Patricia L. Belluomini, RHIA, reveal coding errors—including omission of procedure codes—that make the translation process more challenging.

ICD-10-PCS may prove to be far more challenging for inpatient coders than ICD-10-CM. For some, it may even be downright scary.

Editor's note: This is the first article in a two-part series about ICD-10-PCS root operations.

ICD-10-CM root operations excision and resection are sometimes hard to differentiate. ICD-10-PCS defines excision (B) as cutting out or off, without replacement, a portion of a body part. Resection (T) is almost identical, but involves cutting out or off the entire body part.

Despite a coder's best efforts to learn ICD-10-CM/PCS, there is one variable that could pose a barrier to compliance: physician documentation.

Different studies using different methodologies all point to the same ­conclusion: Coder productivity will decrease after the switch to ICD-10. However, no one knows what will happen to coding accuracy.

The 2014 draft ICD-10-PCS guidelines include a code for the usage of a robotic-assist device in surgery, something coders can currently report in ICD-9-CM. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , compares documentation requirements for coding robotic-assisted surgery in both ICD-9-CM and ICD-10-PCS.

Inpatient coders will see an entirely new coding system October 1 when they begin officially using ICD-10-PCS. However, MS-DRGs are not changing. The only thing that is changing is what codes map to a particular MS-DRG.

ICD-10-PCS codes consist of seven characters, each of which identifies a unique, specific piece of information. For most of the codes in the Medical and Surgical section, each character represents the same information every time.