Take a quick refresher on ICD-10-CM/PCS coding

Different types of health interventions supervised and taken by the Doctors and medical profession are procedurally cataloged in US by a Procedure Coding System called ICD 10 PCS. ICD means International Classification of Diseases. ICD 10 means the 10 the procedure. The treatments and consultation of Doctors for the patients are codes using ICD 10 so that it will be easier for generating bills to pay for the Doctors by the health insurance companies. There are diverse factors about ICD 10 to know since many changes have brought in it from ICD 9.

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The replacement of ninth version of ICD to ICD 10 was done by the year 1993. Now, ICD 10 PCS is the clinical modification of US specific from ICD 10. Actually ICD 10 PCS code is framed for hospital settings and inpatients by the way it is used widely for that.  Important fact regarding ICD 10 PCS is that more codes are added and updated than codes in ICD 9.

The updated codes in ICD 10 are really useful to cover wide range of support for the needs of health information of current scenario. Now, ICD 10 PCS should be utilized on every transactions of HIPAA which is Health Insurance Portability and Accountability Act.

Code structure

CMS - Centers for Medicare and Medicaid Services associating with 3M Health Information Management developed ICD 10 PCS.  This is to track the statistics of mortality and morbidity comparatively.

3 to 7 digits alphanumeric codes are used in ICD 10 codes for specification of medical procedures. In the set of alpha numeric codes the first digit specifies medical practice section such as administration, surgery and monitoring and measuring.

The rest of the digits mention root operation, body system, body parts, devices used and approach handled. Finally the 7th character of the alpha numeric digits is called as qualifying digit.

Example

In the ICD manual for reference the first 3 digits of the code are stored. For instance, if you take 0C0 code, the beginning of the code will be a medical procedure or surgical procedure done on throat or mouth. Let's check ICD 10 PCS code, for instance 047K0ZZ specifies dilation of right femoral artery.

Sections in ICD-10 PCS:

  • Administration
  • Chiropractic
  • Extracorporeal assistance and performance
  • Extracorporeal therapies
  • Imaging
  • Laboratory
  • Measurement and monitoring
  • Medical and surgical
  • Mental health
  • Miscellaneous
  • Nuclear medicine
  • Obstetrics
  • Osteopathic
  • Physical rehabilitation and diagnostic audiology
  • Placement
  • Radiation oncology
  • Substance abuse treatment

ICD 10 PCS are rules that are frames to assist the coding system instruction and these codes are approved by the major four organizations such as American Health Information Management Association, American Hospital Association, and National Centers for Health Statistics, and CMS.