ICD-10-PCS requires coders to possess strong clinical knowledge as well as a solid foundation in anatomy and physiology. Coders need to understand what physicians are actually doing in certain...
We won’t need to learn any new ICD-10-PCS codes or guidelines for 2015. CMS released the draft codes and guidelines and they include not much of anything. That’s not really a surprise since the code...
A patient undergoes a hysterectomy and experiences post-procedural bleeding. The surgeon cauterizes the bleed and evacuates a blood clot. In ICD-10-PCS, how do you code the cauterization? With the...
Sometimes a surgeon must take drastic action and amputate a patient’s upper or lower extremity. For these cases, we would use ICD-10-PCS root operation Detachment (third character 6). ICD-10-PCS...
Map (third character K) is a very narrowly defined ICD-10-PCS root operation. By definition, Map procedures are used to locate the route of passage of electrical impulses and/or locate functional...
Almost all of the ICD-10-PCS root operations describe very specific intent. Think about the difference between root operations excision and resection. Excision involves removing some of a body part...
CMS reversed course earlier this week and announced it will conduct end-to-end ICD-10 training with a sample of providers. Previously, CMS had stated it would not conduct any end-to-end testing...
Odds are, most coders will never use ICD-10-PCS table 0W4. Why? Because root operation 4 is creation (making a new genital structure that does not physically take the place of a body part). Unless...
It’s the gift-giving season and HCPro is giving you free on-demand access to the audio conference, ICD-10-PCS: Coding, Structure and Format, when you sign up for the January 10 live webcast, ICD-10-...
Initially, we thought that outpatient coders didn’t have to learn to code in ICD-10-PCS. They would still use CPT® codes to report physician services in the outpatient world. Now it looks like that...
We have just a little over a year remaining until ICD-10 implementation. How well do you know your ICD-10-PCS codes? ICD-10-CM shares a lot of similarities with ICD-9-CM. Sadly, ICD-9-CM procedure...
In ICD-10-PCS, coders will need to select the root operation based on the objective of the procedure (not what the physician calls it). If the physician’s objective is to strip out by force all of a...
Betsy comes in to Stitch ‘Em Up Hospital suffering from a cerebral aneurysm. Dr. Jannettta performs a vessel embolization procedure to treat Betsy. [caption id="attachment_3480" align="alignright"...
Sometimes our patients are very sick, very injured, or undergo multiple procedures during their stay. So how do you pick your principal procedure code in ICD-10-PCS? The ICD-10-PCS guidelines offer...
The ICD-10-PCS codes for 2014 are now available on the CMS website. CMS also posted the 2014 ICD-10-PCS guidelines and an ICD-10-PCS reference manual. You will find four new codes under new...
When coders begin using ICD-10-PCS the second and fourth character definitions seem simple enough: Second character-Body system Fourth character-Body part However, when coders start assigning codes,...
We all know that procedure coding will change considerably on October 1, 2014 with the implementation of ICD-10-PCS. But what about change as an ICD-10-PCS root operation? In ICD-10-PCS, you will use...
ICD-10-PCS includes specific guidelines for coding spinal fusion procedures, including guidelines for selecting the body part value. The body part for a spinal vertebral joint(s) rendered immobile by...
So far, we’ve covered three different ICD-10-PCS guidelines for multiple procedures. We’ve looked at how to report multiple procedures involving: Same root operation, different body parts as defined...
We’ve already discussed one of the multiple procedure guidelines in ICD-10-PCS, but we still have three more to go. And that’s not counting the guidelines that are not included in the multiple...
The multiple procedure guidelines in ICD-10-PCS present possibilities for coder confusion. Several guidelines relate to the coding of multiple procedures, some under the heading of multiple...
Penny arrived at the Stitch ‘Em Up Hospital with a benign growth on her thyroid gland (ICD-10-CM code D35). The growth isn’t causing any functional problems, so we don’t need to report any additional...
You need enthusiasm and a desire to keeping learning to tackle the monumental task of learning ICD-10-PCS. In authoring an ICD-10 CM/PCS education program 10 hours per work I learn something new...
Outpatient coders currently report procedures using CPT codes. That won’t change after the switch to ICD-10. However, some facilities currently require outpatient coders to also report procedures...
We all know coder productivity will go down after the transition to ICD-10 and it may never rebound to current levels. The question is, how much will productivity decline? It could drop more than you...
Dr. Cap I. Larry is back at work on some blood vessels at Stitch ‘Em Up Hospital. Let’s see what she’s up to today. For all of Dr. Larry’s procedures, we’re going to be coding from the Medical and...
Today we are taking a peek into OR 3 at the Stitch ‘Em Up Hospital to watch Dr. Cap I. Larry work on some blood vessels. Then we’re going to code her procedure. Dr. Larry is harvesting part of the...
By now, you probably know that ICD-10-PCS codes contain seven alpha-numeric characters. Each character represents a specific piece of information and those meanings can vary by section. In the...
If you have looked at the ICD-10-PCS Manual, you know that the codes are arranged in tables based on the first three characters of the code. The table contains all of the possible choices for...
Welcome to Stitch ‘Em Hospital, where we’re preparing for ICD-10-PCS by actually coding some of our procedures using the new system. We want to make sure we’re ready to go on October 1, 2014, and...
When a physician places a device that takes the place of all or some of a body part, assign a code from ICD-10-PCS root operation replacement (third character R). Think of a total knee replacement or...
In ICD-10-PCS, coders will only report a device when the device remains in the patient after the procedure. If it’s removed, it’s not a device and your sixth character will be Z. For many procedures...
As expected, not much has changed for 2013 with ICD-10-PCS codes. The updated code set is now available on the the CMS website . CMS confirmed in April that the code freeze will hold until ICD-10-CM/...
When a physician performs a procedure designed to put in a device without doing anything else to a body part, coders will report ICD-10-PCS root operation insertion (third character H in the medical...
Some ICD-10-PCS root operations encompass a wide range of procedures. Think biopsy, excision, and extraction. Others cover a much smaller range of possible procedures, including fusion. Coders will...
A patient comes in for a face lift or another cosmetic procedure. What root operation should you code the procedure to in ICD-10-PCS? The answer: alteration (third character 0). The goal of an...
When a physician performs a procedure intended to narrow the diameter of a tubular body part or orifice, coders will select the root operation restriction in ICD-10-PCS. Restriction includes both...
When a physician performs a procedure to enlarge the diameter of a tubular body part or orifice, coders will report root operation dilation with 7 as the third character in the medical and surgical...
Not all of the ICD-10-PCS root operations are complicated or confusing. Take reattachment for example. The root operation is pretty much what you would expect. The official definition of reattachment...
And the new proposed ICD-10-CM/PCS implementation date is (drum roll, please)…October 1, 2014. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the new date as part...
When a physician moves a body part to a new place without disrupting its vascular and nervous supply, coders will code to root operation Transfer in ICD-10-PCS. The root operation is indicated by the...
When a physician completely closes the orifice or lumen of a tubular body part, coders will look to the root operation occlusion in ICD-10-PCS. The orifice can be a natural orifice or an artificially...
The ICD-10-PCS defines root operations excision and resection in a very similar way. Excision is cutting out or off, without replacement, a portion of a body part. Coders should report the qualifier...
Some of the ICD-10-PCS root operations are very similar—think excision (cutting out or off, without replacement, a portion of a body part) and resection (cutting out or off, without replacement, all...
Inpatient coders currently can default to “not otherwise specified” (NOS) codes in ICD-9-CM Volume 3, but they won’t have that option as frequently in ICD-10-PCS. Coders report NOS codes when the...
Physicians use devices all the time during procedures. For example, they may place a temporary catheter in a patient, insert a drug-eluting stent, or insert a central line. So when do you report a...
When you hear the word 'transplant', what do you think of first? Many people probably think of organ transplants. If you’re one of those people, you’re all set for the ICD-10-PCS root operation...
While working on various projects related to ICD-10-PCS, I have discovered many areas where I think coders are going to struggle because the rules either go against the way we code now in ICD-9-CM...
Removal sounds like it should be an easy root operation in ICD-10-PCS. Removal means taking something out, right? Physicians remove things all the time—your appendix, a cyst, the toy your son stuck...
When a physician frees a body part from an abnormal physical constraint by cutting or by use of force, coders will use the root operation release (N) in ICD-10-PCS. Keep in mind, though, that you...
In ICD-10-PCS, coders assign the root operation bypass (third character 1) when the surgeon’s objective in the procedure is to reroute the contents of a tubular body part. Bypass procedures includes...
In the medical and surgical section of ICD-10-PCS, character 5 refers to the approach or method used to reach or expose a body part during a procedure. As a result, coders will need to look for...
The American Medical Association (AMA) House of Delegates voted to “work vigorously to stop implementation of ICD-10” during the closing session of its semi-annual policy-making meeting November 15...
Coders will use the root operation division when the physician plans to cut into, transect, or otherwise separate all or a portion of a body part. Do not use division if the physician plans to cut or...
Another new term coders will need to know for ICD-10-PCS root operations is fragmentation. Fragmentation is breaking solid matter in the body into pieces. Note that in a fragmentation procedure, the...
When should a coder report multiple procedures performed during a single operative session in ICD-10-PCS? Look to the official guidelines for information. According to the guidelines, coders should...
Some of the removal root operations can easily be confused with other root operations that involve taking out solids, fluids, or gases from a body part (e.g., drainage, extirpation, and fragmentation...
A step-by-step approach to code assignment is helpful when trying to understand the complexity of ICD-10-PCS. Step one: Determine the first character, which denotes the general category of the...
If an excision involves cutting out a portion of a body part, and a resection involves cutting out all of a body part, what then is an extraction? According to the ICD-10-PCS guidelines, an...
With ICD-10-PCS, coders will have 31 root operations to choose from and not all of them are clear cut. Start learning the root operations now to prepare you for the switch to ICD-10-PCS. The ICD-10-...
If you haven’t already done so, now is a good time to look at your system capabilities and see what you need to update or upgrade before the transitions to HIPAA Version 5010 and ICD-10-CM/PCS. Start...
So the transition to ICD-10-CM/PCS is still more than two years away, and it’s too early to start learning actual codes. But you can start reviewing some of the major concepts of ICD-10-CM/PCS with...
ICD-10-PCS codes include one digit for the root operation that the provider performs. The root operation is always the third character is the seven-character code. The definitions of these root...
CMS recently posted the 2012 ICD-10-PCS codes and coding guidelines . A summary of the major changes for 2012 states that there are 1,182 new codes, 381 revised titles, and 1,345 deleted codes. In...
You’ve probably heard that it’s too early to start learning ICD-10-CM/PCS codes. After all, the codes are still in draft format. However, it’s not too early to start learning the root operations for...
Coders are discussing whether they need to be trained in ICD-10-CM only or should they also receive training in ICD-10-PCS. Well, the answer may depend on what setting you are currently employed in,...
ICD-10-CM/PCS now has guidelines for reporting conditions that are present on admission (POA). As part of the 2011 guidelines updates, CMS and the National Center for Health Statistics added Appendix...
The Centers for Disease Control (CDC) posted the new 2011 guidelines for ICD-10-CM on its website. You won’t find many significant changes to conventions, general coding guidelines, and chapter...
CMS has posted two new frequently asked questions (FAQs) about ICD-10 national provider teleconferences and the partial code freeze. To access these FAQs, please visit the CMS ICD-10 webpage , click...
Physicians who are part of a practice do go to the hospital to deliver babies, provide consults, and perform surgeries. So does that mean coders in a physician’s office will need to learn ICD-10-PCS...
When coders are looking at scenarios in ICD-10-CM/PCS, where the X is located within the code matters. When X is in the fifth and/or sixth character, X is a placeholder. ICD-10-CM codes can be up to...
CMS has released the 2011 versions of the ICD-10-CM/PCS crosswalks, also known as the General Equivalence Mappings (GEM) on its ICD-10 website . In addition, CMS also posted a document titled “ICD-10...
Looking forward to it? Did I really just say that? Yep – I sure did! In July, I attended a preview of HCPro’s ICD-10 Basics Boot Camp ™. I was actually a little surprised that the ICD-10-CM codes,...
CMS posted this week the following ICD-10-PCS files for 2011 to its website: Official ICD-10-PCS Coding Guidelines 2011 Version: What's New Code Tables and Index Code Descriptions ICD-10-PCS...
OK, so maybe your ICD-10-PCS (Draft) Manual doesn't rank up there with your most memorable reads, however, you can't deny that it's a page-turner! Sometimes, it may seem like you can't find the...
ICD-10-PCS is drastically different from the ICD-9-CM Volume 3 procedure codes. Just looking at the physical appearance, you’ll see that the procedure codes in ICD-9-CM have a maximum of four digits...
CMS recently posted updates to both the 2010 ICD-10-CM Guidelines for Coding and Reporting and the ICD-10-PCS mappings , "ICD-10-PCS to ICD-9-CM" and "ICD-9-CM to ICD-10-PCS." Regarding the ICD-10-...
I have always thought that ICD-9 procedure codes were very non-specific and that it is no wonder that inpatient coders don’t like CPT coding. However after looking at what is going to happen with ICD...
