ICD-10-CM 2019 The Complete Official Codebook

866 Pages·2018·15.97 MB·English

by  American Medical Association

ICD-10-PCS 2019 2 2019
0
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The Complete Official Codebook 9
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2019
ICD 10 PCS
The Complete Official Codebook
Notice Anita Schmidt, BS, RHIT, AHIMA-approved
ICD-10-CM/PCS Trainer
ICD-10-PCS: The Complete Official Codebook is designed to be
an accurate and authoritative source regarding coding and Ms. Schmidt has expertise in Level I adult and pediatric
every reasonable effort has been made to ensure accuracy trauma hospital coding, specializing in ICD-9-CM,
and completeness of the content. However, the AMA ICD-10-CM/PCS, DRG, and CPT coding. Her experience
makes no guarantee, warranty, or representation that this includes analysis of medical record documentation,
publication is accurate, complete, or without errors. It is assignment of ICD-10-CM and PCS codes, DRG validation,
understood that the AMA is not rendering any legal or as well as CPT code assignments for same-day surgery
other professional services or advice in this publication cases. She has conducted coding training and auditing,
and that the AMA bears no liability for any results or including DRG validation, conducted electronic health
consequences that may arise from the use of this book. record training, and worked with clinical documentation
specialists to identify documentation needs and potential
areas for physician education. Most recently she has been
Our Commitment to Accuracy developing content for resource and educational products
related to ICD-10-CM and ICD-10-PCS. Ms. Schmidt is an
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Peggy Willard, CCS, AHIMA-approved
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at amastore.com. Refer to product number OP201119. Ms. Willard has 18 years of experience in the healthcare
field. Her expertise is in ICD-10-CM and ICD-10-PCS,
including in-depth analysis of medical record
Copyright documentation, ICD-10-CM/PCS code and DRG
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Marianne Randall, CPC, Product Manager facility (IRF) coding, specializing in ICD-9-CM diagnosis
Karen Schmidt, BSN, Technical Director and procedural coding, with emphasis in conducting
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Trainer, Clinical Technical Editor staff and clinical documentation specialists. Ms. Willard is
Peggy Willard, CCS, AHIMA-approved ICD-10-CM/PCS an AHIMA-approved ICD-10 CM/PCS trainer and is an
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What’s New for 2019
The Centers for Medicare and Medicaid Services is the agency charged New Definitions Addenda
with maintaining and updating ICD-10-PCS. CMS released the most
current revisions, a summary of which may be found on the CMS Section 0 - Medical and Surgical
website at: https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-
Body Part Definitions
10-PCS-and-GEMs.html
ICD-10-PCS Value Definition
Due to the unique structure of ICD-10-PCS, a change in a character
value may affect individual codes and several code tables. Head and Neck Bursa and Ligament Delete Interspinous ligament
Add Interspinous ligament,
Change Summary Table cervical
Add Intertransverse ligament,
2018 Total New Codes Revised Titles Deleted Codes 2019 Total cervical
Add Ligamentum flavum, cervical
78,705 392 8 216 78,881
Lower Spine Bursa and Ligament Delete Interspinous ligament
ICD-10-PCS Code FY 2019 Totals, By Section Delete Intertransverse ligament
Delete Ligamentum flavum
Medical and Surgical 68,639 Add Interspinous ligament,
lumbar
Obstetrics 302
Add Intertransverse ligament,
Placement 861 lumbar
Administration 1,445 Add Ligamentum flavum, lumbar
Measurement and Monitoring 414
Add Mediastinum Add Mediastinal cavity
Extracorporeal or Systemic Assistance and Performance 45 Add Mediastinal space
Extracorporeal or Systemic Therapies 46
Retroperitoneum Add Retroperitoneal cavity
Osteopathic 100
Rib(s) Bursa and Ligament Delete Costoxiphoid ligament
Other Procedures 60
Delete Sternocostal ligament
Chiropractic 90
Sternum Bursa and Ligament Delete Costotransverse ligament
Imaging 2,941
Nuclear Medicine 463 Upper Spine Bursa and Ligament Delete Interspinous ligament
Delete Intertransverse ligament
Radiation Therapy 1,939
Delete Ligamentum flavum
Physical Rehabilitation and Diagnostic Audiology 1,380 Add Interspinous ligament,
Mental Health 30 thoracic
Add Intertransverse ligament,
Substance Abuse Treatment 59
thoracic
New Technology 67 Add Ligamentum flavum, thoracic
Total 78,881
Section 0 - Medical and Surgical
ICD-10-PCS Changes Highlights Device Definitions
• In the Medical and Surgical section, body part values revised or
ICD-10-PCS Value Definition
streamlined for clarity and usefulness as coded data
• ICD-10-PCS guidelines updated with new and revised guidelines Add Articulating Spacer in Add Articulating Spacer
Lower Joints (Antibiotic)
• Root operation Control was added to the Ear, Nose and Sinus body Add Spacer, Articulating
system for the body part of Nasal Mucosa and Soft Tissue (Antibiotic)
• Root Operation Extraction was added to the Hepatobiliary System Spacer in Lower Joints Add Spacer, Static (Antibiotic)
and Pancreas body system Add Static Spacer (Antibiotic)
• The No Device value was removed from the Fusion root operation
tables
• Unicondylar devices (Medial and Lateral) and Articulating Spacers
were added to the Removal table and Replacement table in the
Lower Joints body system
• New qualifiers were added to identify:
— More specificity for Bypass procedures
— Drug coated balloon use in Dilation procedures
— Stent Retriever use in Extirpation procedures
— Use of irreversible electroporation in Destruction procedures
ICD-10-PCS 2019 iii
What’s New for 2019 ICD-10-PCS 2019
Section 0 - Medical and Surgical
Device Aggregation Table
Specific Device for Operation in Body System General Device
Delete Synthetic Substitute, Delete Replacement Delete Lower Joints Delete J Synthetic Substitute
Unicondylar
Section X - New Technology 2019 ICD-10-PCS Code Tables and Index (Zip file)
Root Operation • Code tables for use beginning October 1, 2018
• Downloadable PDF, file name is pcs_2019.pdf
ICD-10-PCS Value Definition
• Downloadable xml files for developers, file names are
Add Destruction Add Definition: Physical icd10pcs_tables_2019.xml, icd10pcs_index_2019.xml,
eradication of all or a portion icd10pcs_definitions_2019.xml
of a body part by the direct
use of energy, force, or a • Accompanying schema for developers, file names are
destructive agent icd10pcs_tables.xsd, icd10pcs_index.xsd,
Add Explanation: None of the icd10pcs_definitions.xsd
body part is physically taken
out 2019 ICD-10-PCS Codes File (Zip file)
Add Includes/Examples:
• ICD-10-PCS Codes file is a simple format for non-technical uses,
Fulguration of rectal polyp,
containing the valid FY 2019 ICD-10-PCS codes and their long
cautery of skin lesion
titles.
Section X - New Technology • File is in text file format, file name is icd10pcs_codes_2019.txt
Approach • Accompanying documentation for codes file, file name is
icd10pcsCodesFile.pdf
ICD-10-PCS Value Definition
• Codes file addenda in text format, file name is
Add Via Natural or Artificial Add Definition: Entry of codes_addenda_2019.txt
Opening Endoscopic instrumentation through a
natural or artificial external 2019 ICD-10-PCS Order File (Long and Abbreviated Titles) (Zip file)
opening to reach and
• ICD-10-PCS order file is for developers, provides a unique five-digit
visualize the site of the
“order number” for each ICD-10-PCS table and code, as well as a
procedure
long and abbreviated code title.
Section X - New Technology
• ICD-10-PCS order file name is icd10pcs_order_2019.txt
Device / Substance / Technology
• Accompanying documentation for tabular order file, file name is
icd10pcsOrderFile.pdf
ICD-10-PCS Value Definition
• Tabular order file addenda in text format, file name is
Engineered Autologous Chimeric Add KYMRIAH
order_addenda_2019.txt
Antigen Receptor T-cell Add Tisagenlecleucel
Immunotherapy 2019 ICD-10-PCS Final Addenda (Zip file)
• Addenda files in downloadable PDF, file names are
Add Synthetic Human Add Angiotensin II
Angiotensin II Add GIAPREZA™ tables_addenda_2019.pdf, index_addenda_2019.pdf,
definitions_addenda_2019.pdf
Add Human angiotensin II,
synthetic
• Addenda files also in machine readable text format for developers,
file names are tables_addenda_2019.txt,
List of Updated Files index_addenda_2019.txt, definitions_addenda_2019.txt
2019 Official ICD-10-PCS Coding Guidelines 2019 ICD-10-PCS Conversion Table (Zip file)
• New Guideline B3.17 added in response to public comment. • ICD-10-PCS code conversion table is provided to assist users in
data retrieval, in downloadable Excel spreadsheet, file name is
• Guidelines A10, B3.7, and B6.1a revised in response to public
icd10pcs_conversion_table_2019.xlsx
comment and internal review.
• Conversion table also in machine readable text format for
• Downloadable PDF, file name pcs_guidelines_2019.pdf
developers, file name is icd10pcs_conversion_table_2019.txt
• Accompanying documentation for code conversion table, file
name is icd10pcsConversionTable.pdf
iv ICD-10-PCS 2019
Introduction
History of ICD-10-PCS In the development of ICD-10-PCS, several additional general
characteristics were added:
The World Health Organization has maintained the International
Classification of Diseases (ICD) for recording cause of death since 1893.
• Diagnostic information is not included in procedure
It has updated the ICD periodically to reflect new discoveries in
description: When procedures are performed for specific diseases
epidemiology and changes in medical understanding of disease.
or disorders, the disease or disorder is not contained in the
procedure code. The diagnosis codes, not the procedure codes,
The International Classification of Diseases Tenth Revision (ICD-10),
specify the disease or disorder.
published in 1992, is the latest revision of the ICD. The WHO authorized
the National Center for Health Statistics (NCHS) to develop a clinical • Explicit not otherwise specified (NOS) options are restricted:
modification of ICD-10 for use in the United States. This version, called Explicit “not otherwise specified,” (NOS) options are restricted in
ICD-10-CM, is intended to replace the previous U.S. clinical ICD-10-PCS. A minimal level of specificity is required for each
modification, ICD-9-CM, that has been in use since 1979. ICD-9-CM component of the procedure.
contains a procedure classification; ICD-10-CM does not.
• Limited use of not elsewhere classified (NEC) option: Because
CMS, the agency responsible for maintaining the inpatient procedure all significant components of a procedure are specified in
code set in the United States, contracted with 3M Health Information ICD-10-PCS, there is generally no need for a “not elsewhere
Systems in 1993 to design and then develop a procedure classification classified” (NEC) code option. However, limited NEC options are
system to replace volume 3 of ICD-9-CM. incorporated into ICD-10-PCS where necessary. For example, new
devices are frequently developed, and therefore it is necessary to
The result, ICD-10-PCS, was initially completed in 1998. The code set provide an “other device” option for use until the new device can
has been updated annually since that time to ensure that ICD-10-PCS be explicitly added to the coding system.
includes classifications for new procedures, devices, and technologies.
• Level of specificity: All procedures currently performed can be
specified in ICD-10-PCS. The frequency with which a procedure is
The development of ICD-10-PCS had as its goal the incorporation of the
performed was not a consideration in the development of the
following major attributes:
system. A unique code is available for variations of a procedure
that can be performed.
• Completeness: There should be a unique code for all
substantially different procedures.
ICD-10-PCS code structure results in qualities that optimize the
• Unique definitions: Because ICD-10-PCS codes are constructed performance of the system in electronic applications, and maximize the
of individual values rather than lists of fixed codes and text usefulness of the coded healthcare data. These qualities include:
descriptions, the unique, stable definition of a code in the system
• Optimal search capability: ICD-10-PCS is designed for maximum
is retained. New values may be added to the system to represent a
versatility in the ability to aggregate coded data. Values belonging
specific new approach or device or qualifier, but whole codes by
to the same character as defined in a section or sections can be
design cannot be given new meanings and reused.
easily compared, since they occupy the same position in a code.
• Expandability: As new procedures are developed, the structure This provides a high degree of flexibility and functionality for data
of ICD-10-PCS should allow them to be easily incorporated as mining.
unique codes.
• Consistent characters and values: Stability of characters and
• Multi-axial codes: ICD-10-PCS codes should consist of values across vast ranges of codes provides the maximum degree
independent characters, with each individual component of functionality and flexibility for the collection and analysis of
retaining its meaning across broad ranges of codes to the extent data. Because the character definition is consistent, and only the
possible. individual values assigned to that character differ as needed,
meaningful comparisons of data over time can be conducted
• Standardized terminology: ICD-10-PCS should include
across a virtually infinite range of procedures.
definitions of the terminology used. While the meaning of specific
words varies in common usage, ICD-10-PCS should not include • Code readability: ICD-10-PCS resembles a language in the sense
multiple meanings for the same term, and each term must be that it is made up of semi-independent values combined by
assigned a specific meaning. There are no eponyms or common following the rules of the system, much the way a sentence is
procedure terms in ICD-10-PCS. formed by combining words and following the rules of grammar
and syntax. As with words in their context, the meaning of any
• Structural integrity: ICD-10-PCS can be easily expanded without
single value is a combination of its position in the code and any
disrupting the structure of the system. ICD-10-PCS allows unique
preceding values on which it may be dependent.
new codes to be added to the system because values for the seven
characters that make up a code can be combined as needed. The
system can evolve as medical technology and clinical practice
evolve, without disrupting the ICD-10-PCS structure.
ICD-10-PCS 2019 1
Introduction ICD-10-PCS 2019
ICD-10-PCS Code Structure ICD-10-PCS Manual
ICD-10-PCS has a seven-character alphanumeric code structure. Each
Index
character contains up to 34 possible values. Each value represents a
specific option for the general character definition. The 10 digits 0–9 Codes may be found in the index based on the general type of
and the 24 letters A–H, J–N, and P–Z may be used in each character. The procedure (e.g., resection, transfusion, fluoroscopy), or a more
letters O and I are not used so as to avoid confusion with the digits 0 commonly used term (e.g., appendectomy). For example, the code for
and 1. An ICD-10-PCS code is the result of a process rather than as a percutaneous intraluminal dilation of the coronary arteries with an
single fixed set of digits or alphabetic characters. The process consists intraluminal device can be found in the Index under Dilation, or a
of combining semi-independent values from among a selection of synonym of Dilation (e.g., angioplasty). The Index then specifies the first
values, according to the rules governing the construction of codes. three or four values of the code or directs the user to see another term.
Example:
n h
Section Body System Root Operatio Body Part Approac Device Qualifier DilaAtriotenry
Coronary
Characters: 1 2 3 4 5 6 7 One Artery 0270
Based on the first three values of the code provided in the Index, the
A code is derived by choosing a specific value for each of the seven
corresponding table can be located. In the example above, the first
characters. Based on details about the procedure performed, values for
each character specifying the section, body system, root operation, three values indicate table 027 is to be referenced for code completion.
body part, approach, device, and qualifier are assigned. Because the The tables and characters are arranged first by number and then by
definition of each character is also a function of its physical position in
letter for each character (tables for 00-, 01-, 02-, etc., are followed by
the code, the same letter or number placed in a different position in the those for 0B-, 0C-, 0D-, etc., followed by 0B1, 0B2, etc., followed by 0BB,
code has a different meaning.
0BC, 0BD, etc.).
The seven characters that make up a complete code have specific Note: The Tables section must be used to construct a complete and
meanings that vary for each of the 17 sections of the manual.
valid code by specifying the last three or four values.
Procedures are then divided into sections that identify the general type
Tables
of procedure (e.g., Medical and Surgical, Obstetrics, Imaging). The first
The Tables are composed of rows that specify the valid combinations of
character of the procedure code always specifies the section. The
code values. In most sections of the system, the upper portion of each
second through seventh characters have the same meaning within
table contains a description of the first three characters of the
each section, but may mean different things in other sections. In all
procedure code. In the Medical and Surgical section, for example, the
sections, the third character specifies the general type of procedure
first three characters contain the name of the section, the body system,
performed (e.g., Resection, Transfusion, Fluoroscopy), while the other
and the root operation performed.
characters give additional information such as the body part and
approach.
For instance, the values 027 specify the section Medical and Surgical (0),
the body system Heart and Great Vessels (2) and the root operation
In ICD-10-PCS, the term procedure refers to the complete specification
Dilation (7). As shown in table 027, the root operation (Dilation) is
of the seven characters.
accompanied by its definition.
Number of Codes in ICD-10-PCS The lower portion of the table specifies all the valid combinations of
characters 4 through 7. The four columns in the table specify the last
The table structure of ICD-10-PCS permits the specification of a large
four characters. In the Medical and Surgical section they are labeled
number of codes on a single page. At the time of this publication, there
body part, approach, device and qualifier, respectively. Each row in the
are 78,881 codes in the 2019 ICD-10-PCS.
table specifies the valid combination of values for characters 4
through 7.
2 ICD-10-PCS 2019
ICD-10-PCS 2019 Introduction
Table 1: Row from table 027
0 Medical and Surgical
2 Heart and Great Vessels 027
7 Dilation Definition: Expanding an orifice or the lumen of a tubular body part
Explanation: The orifice can be a natural orifice or an artificially created orifice. Accomplished by stretching a tubular body part using
intraluminal pressure or by cutting part of the orifice or wall of the tubular body part.
Body Part Approach Device Qualifier
Character 4 Character 5 Character 6 Character 7
0 Coronary Artery, One Artery 0 Open 4 Intraluminal Device, Drug-eluting 6 Bifurcation
1 Coronary Artery, Two Arteries 3 Percutaneous 5 Intraluminal Device, Drug-eluting, Z No Qualifier
2 Coronary Artery, Three Arteries 4 Percutaneous Endoscopic Two
3 Coronary Artery, Four or More 6 Intraluminal Device, Drug-eluting,
Arteries Three
7 Intraluminal Device, Drug-eluting,
Four or More
D Intraluminal Device
E Intraluminal Device, Two
F Intraluminal Device, Three
G Intraluminal Device, Four or More
T Intraluminal Device, Radioactive
Z No Device
The rows of this table can be used to construct 240 unique procedure
027037Z Dilation of Coronary Artery, One Artery with Four or More
codes. For example, code 02703DZ specifies the procedure for dilation
Drug-eluting Intraluminal Devices, Percutaneous
of one coronary artery using an intraluminal device via percutaneous
Approach
approach (i.e., percutaneous transluminal coronary angioplasty with
02703DZ Dilation of Coronary Artery, One Artery with Intraluminal
stent).
Device, Percutaneous Approach
The valid codes shown in table 2 are constructed using the first body 02703EZ Dilation of Coronary Artery, One Artery with Two
part value in table 1 (i.e., one coronary artery), combined with all the Intraluminal Devices, Percutaneous Approach
valid approaches and devices listed in the table, and the value “No
02703FZ Dilation of Coronary Artery, One Artery with Three
Qualifier”.
Intraluminal Devices, Percutaneous Approach
Table 2: Code titles for dilation of one coronary artery (0270) 02703GZ Dilation of Coronary Artery, One Artery with Four or More
Intraluminal Devices, Percutaneous Approach
027004Z Dilation of Coronary Artery, One Artery with Drug-eluting
Intraluminal Device, Open Approach 02703TZ Dilation of Coronary Artery, One Artery with Radioactive
Intraluminal Device, Percutaneous Approach
027005Z Dilation of Coronary Artery, One Artery with Two
Drug-eluting Intraluminal Devices, Open Approach 02703ZZ Dilation of Coronary Artery, One Artery, Percutaneous
Approach
027006Z Dilation of Coronary Artery, One Artery with Three
Drug-eluting Intraluminal Devices, Open Approach 027044Z Dilation of Coronary Artery, One Artery with Drug-eluting
Intraluminal Device, Percutaneous Endoscopic Approach
027007Z Dilation of Coronary Artery, One Artery with Four or More
Drug-eluting Intraluminal Devices, Open Approach 027045Z Dilation of Coronary Artery, One Artery with Two
Drug-eluting Intraluminal Devices, Percutaneous
02700DZ Dilation of Coronary Artery, One Artery with Intraluminal
Endoscopic Approach
Device, Open Approach
027046Z Dilation of Coronary Artery, One Artery with Three
02700EZ Dilation of Coronary Artery, One Artery with Two
Drug-eluting Intraluminal Devices, Percutaneous
Intraluminal Devices, Open Approach
Endoscopic Approach
02700FZ Dilation of Coronary Artery, One Artery with Three
027047Z Dilation of Coronary Artery, One Artery with Four or More
Intraluminal Devices, Open Approach
Drug-eluting Intraluminal Devices, Percutaneous
02700GZ Dilation of Coronary Artery, One Artery with Four or More Endoscopic Approach
Intraluminal Devices, Open Approach
02704DZ Dilation of Coronary Artery, One Artery with Intraluminal
02700TZ Dilation of Coronary Artery, One Artery with Radioactive Device, Percutaneous Endoscopic Approach
Intraluminal Device, Open Approach
02704EZ Dilation of Coronary Artery, One Artery with Two
02700ZZ Dilation of Coronary Artery, One Artery, Open Approach Intraluminal Devices, Percutaneous Endoscopic Approach
027034Z Dilation of Coronary Artery, One Artery with Drug-eluting 02704FZ Dilation of Coronary Artery, One Artery with Three
Intraluminal Device, Percutaneous Approach Intraluminal Devices, Percutaneous Endoscopic Approach
027035Z Dilation of Coronary Artery, One Artery with Two 02704GZ Dilation of Coronary Artery, One Artery with Four or More
Drug-eluting Intraluminal Devices, Percutaneous Intraluminal Devices, Percutaneous Endoscopic Approach
Approach
02704TZ Dilation of Coronary Artery, One Artery with Radioactive
027036Z Dilation of Coronary Artery, One Artery with Three Intraluminal Device, Percutaneous Endoscopic Approach
Drug-eluting Intraluminal Devices, Percutaneous
02704ZZ Dilation of Coronary Artery, One Artery, Percutaneous
Approach
Endoscopic Approach
ICD-10-PCS 2019 3
Introduction ICD-10-PCS 2019
Table 3: Rows from table 00H
0 Medical and Surgical
0 Central Nervous System and Cranial Nerves 00H
H Insertion Definition: Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically
take the place of a body part
Explanation: None
Body Part Approach Device Qualifier
Character 4 Character 5 Character 6 Character 7
0 Brain 0 Open 2 Monitoring Device Z No Qualifier
Cerebrum 3 Infusion Device
Corpus callosum 4 Radioactive Element,
Encephalon Cesium-131 Collagen
Implant
M Neurostimulator Lead
Y Other Device
0 Brain 3 Percutaneous 2 Monitoring Device Z No Qualifier
Cerebrum 4 Percutaneous Endoscopic 3 Infusion Device
Corpus callosum M Neurostimulator Lead
Encephalon
Y Other Device
6 Cerebral Ventricle E Cranial Nerve 0 Open 2 Monitoring Device Z No Qualifier
Aqueduct of Sylvius U Spinal Canal 3 Percutaneous 3 Infusion Device
Cerebral aqueduct (Sylvius) Epidural space, spinal 4 Percutaneous Endoscopic M Neurostimulator Lead
Choroid plexus Extradural space, spinal Y Other Device
Ependyma Subarachnoid space,
Foramen of Monro spinal
(intraventricular) Subdural space, spinal
Fourth ventricle Interventricular Vertebral canal
foramen (Monro) V Spinal Cord
Left lateral ventricle
Right lateral ventricle
Third ventricle
Table 3, is split into three rows; values of characters must all be selected separately and value selection must be made within the same row of
from within the same row of the table. Row 1 and 2 indicate that the the table.
body part (character 4) value 0 and Qualifier value Z may both be used
in combination with device values 2, 3, M or Y. However, the approach Character Meanings
(character 5) and device (character 6) values are not exactly the same In each section, each character has a specific meaning, and this
for both rows. As shown in row 1, Body part value Brain (0) with Device character meaning remains constant within that section. Character
value Radioactive Element, Cesium-131 Collagen Implant (4) can only meaning tables have been provided at the beginning of each section or,
be used with approach value Open (0). In other words, code 00H034Z in the case of the Medical and Surgical section (0), at the beginning of
would be invalid as the approach value 3 is only applicable to row 2 and each body system to help the user identify the character members
the device value 4 is only applicable to row 1. It would be inappropriate available within that section. These tables have purple headers, unlike
to build a code for body part 0 if all of the values are not contained in its the official code tables that have green headers and SHOULD NOT be
own row. used to build a PCS code. Following is an excerpt of a character
meaning table.
Note: In this manual, there are instances in which some tables due to
length must be continued on the next page. Each section must be used
Table 4: Rows from Central Nervous System and Cranial Nerves - Character Meanings Table
Operation–Character 3 Body Part–Character 4 Approach–Character 5 Device–Character 6 Qualifier–Character 7
1 Bypass 0 Brain 0 Open 0 Drainage Device 0 Nasopharynx
2 Change 1 Cerebral Meninges 3 Percutaneous 2 Monitoring Device 1 Mastoid Sinus
5 Destruction 2 Dura Mater 4 Percutaneous Endoscopic 3 Infusion Device 2 Atrium
7 Dilation 3 Epidural Space, Intracranial X External 4 Radioactive Element, 3 Blood Vessel
Cesium-131 Collagen Implant
8 Division 4 Subdural Space, Intracranial 7 Autologous Tissue Substitute 4 Pleural Cavity
9 Drainage 5 Subarachnoid Space, J Synthetic Substitute 5 Intestine
Intracranial
B Excision 6 Cerebral Ventricle K Nonautologous Tissue 6 Peritoneal Cavity
Substitute
C Extirpation 7 Cerebral Hemisphere M Neurostimulator Lead 7 Urinary Tract
D Extraction 8 Basal Ganglia Y Other Device 8 Bone Marrow
F Fragmentation 9 Thalamus Z No Device 9 Fallopian Tube
H Insertion A Hypothalamus B Cerebral Cisterns
J Inspection B Pons F Olfactory Nerve
4 ICD-10-PCS 2019