The document discusses the structure of ICD-10 PCS codes compared to ICD-9 PCS codes, emphasizing that ICD-10 consists of 16 sections, focusing on the medical & surgical section which codes are 7 characters long. It details the importance of accurately determining body systems and root operations, and the unique coding rules that must be followed to produce valid codes. Additionally, the document provides guidelines for ensuring codes adhere to the correct format and highlights key resources for further learning.

1. When making a comparison of the ICD-10 PCS code structure to that
of the ICD-9 PCS code structure; the coder should throw everything
out the window and start from scratch while keeping the following in
mind:
ICD-10 PCS is comprised of 16 sections represented by the numbers 0-
9 and the letters B-D and F-H. The 16 sections are subdivided into
main sections: Medical & Surgical; Medical & Surgical-related and
Ancillary Sections.
All codes in the Medical & Surgical Section begin with 0 and contain
the majority of procedures used in the inpatient setting.
All codes in ICD-10 PCS are 7 characters in length and each of the
characters represent an aspect of the procedure. The 7 characters in
the Medical & Surgical Section are: Medical & Surgical, Body
System, Root Operation, Body Part, Approach, Device, and Qualifier
respectively.
1st Character=Medical Surgical
2nd Character=Body System
3rd Character=Root Operation
4th
Character=Body Part
5th
Character=Approach
6th
Character=Device
7th
Character=Qualifier
Medical &
Surgical
(0)
Body
System
Root
Operatio
n
Body
Part
Approac
h
Device
Qualifier
THE STRUCTURE OF THE CODE
WHAT TO EXPECT
1 The Structure of the Code
2 Body Systems & Root
Operations
3 What is a Valid Code?
4 Requests for Coding Topics
May 2015
Volume 2 Issue 4
By Cynthia Brown, MBA, RHIT, CCS
www.cyntcodinghealthinformationservices.com
CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984
Gain Knowledge of Medical Coding Through E -Learning
Cynthia@cyntcodinghealthinformationservices.com [phone]
CODING YESTERDAY’S NOMENCLATURE TODAY®
ICD-10 PCS MEDICAL & SURGICAL SECTION
CODE STRUCTURE
CODING NEWSLETTER FOR HEALTHCARE
CODING PROFESSIONALS

2. Page 2 Coding Yesterday’s Nomenclature Today
There are 31 Body Systems in the Medical & Surgical Section along
with 31 Root Operations (not all are used in each Body System).
BODY SYSTEMS:
The procedure codes in the general anatomical regions should only be
used when the procedure is performed on an anatomical region rather
than a specific body part or when there is no information available to
support a specific body part.
ROOT OPERATIONS:
In order to determine the appropriate root operation, the full definition
of the root operation as defined in the PCS Tables must be applied.
The coder should take full advantage of the definition keys found in the
Tables and Index. They are the Body Part Key, Device Key, Substance
Key, and Device Aggregation Key.
Purchase the “ICD-10 PCS Medical & Surgical Reference Guide” for
more guidelines and reference material; which is found at
https://sites.google.com/a/cyntcodinghealthinformationservices.com/gain-knowledge-
of-medical-coding-through-e-learning/e-books.
www.cyntcodinghealthinformationservices.com
CNS PNS
Heart
& Great
Vessels
Upper
Arteries
Lower
Arteries
Upper
Veins
Lower
Veins
Lymphatic
& Hemic
Systems
Eye ENT
Respirator
y
System
Mouth &
Throat
Gastrointestin
al
System
Hepatobilia
ry System &
Pancreas
Endocrine
System
Skin &
Breast
Subcutaneou
s
Tissue &
Fascia
Muscles Tendons
Bursae&
Ligaments
Head &
Facial
Bones
Upper
Bones
Lower
Bones
Upper
Joints
Lower
Joints
Urinary
System
Female
Reproducti
ve
System
Male
Reproducti
ve
System
Anatomic
al Regions
General
Anatomic
al Regions
Upper
Extremitie
s
Anatomic
al Regions
Lower
Extremitie
s
Excision Resection
Detachme
nt
Destruction Extraction Drainage
Extirpatio
n
Fragmentati
on
Division Release
Transplantati
on
Reattachme
nt
Transfer
Repositio
n
Restrictio
n
Occlusion Dilation Bypass Insertion Replaceme
nt
Suppleme
nt
Change Removal Revision Inspection Map Repair Control Fusion Alteration Creation
“Take advantage of the definition
keys”
The full definition of the root
operation must be applied.
BODY SYSTEMS & ROOT OPERATIONS

3. Coding Yesterday’s Nomenclature Today
WHAT IS A VALID CODE?
To produce a valid 7 character code, the coder must refer to ICD-10 PCS Tables and
Index. The alphabetic index is used to locate the appropriate table used in building a
code. The table should ALWAYS be used when determining the appropriate
procedural code. A unique feature of ICD-10 PCS is the coder’s ability to obtain a
complete and accurate code by using the table only. This is not true in ICD-9 PCS;
the coder must first refer to the alphabetic index and then cross-check the code using
the Tabular List. All seven characters must be specified for there to be a valid code.
Query the physician for more specificity when one of the characters cannot be
specified.
Within the PCS Table, valid codes include all combinations of choices in character 4
through 7 contained in the SAME row of the table. The numbers 0 through 9 are
used to specify characters in ICD-10 PCS along with the letters of the alphabets with
the exception of the letters O and I.
Compare the codes with the table to help you differentiate between valid and invalid
PCS codes.
Valid Codes:
08123J4 08133J4 081X0J3 081X3J3 081Y0J3 081Y3J3
08123K4 08133K4 081X0K3 081X3K3 081Y0K3 081Y3K3
08123Z4 08133Z4 081X0Z3 081X3Z3 081Y0Z3 081Y3Z3
Notice how the characters are contained in the same row for each of the codes.
Invalid Codes:
08120J4 08130J4 08123J3 08133J3
08120K4 08130K4 OR 08123K3 08133K3
08120Z4 08130Z4 08123Z3 08133Z3
Notice there is not an “Open” Approach character for “Body Parts” Anterior
Chamber, Right or Left. If you stay on the same row as the “Body Parts” Anterior
Chamber Right or Left; the only option for the “Approach” is Percutaneous.
In the second set of invalid codes, the “Qualifier” Sclera Cavity cannot be used for the
“Body Parts” Anterior Chamber, Right or Left. The “Qualifier” Sclera Cavity is not on
the same row as the “Body Parts” Anterior Chamber, Right or Left. Your only option
for the “Body Parts” Anterior Chamber, Right or Left “Qualifier” is Sclera; because it
is on the same row.
Section 0 Medical and Surgical
Body System 8 Eye
Root Operation 1 Bypass
Body Part Approach Device Qualifier
2 Ant. Chamber, RT
3 Ant. Chamber, LT
3 Percutaneous J Synthetic Substitute
K Nonautologous Tissue
Z No Device
4 Sclera
X Lacrimal Duct, RT
Y Lacrimal Duct. LT
0 Open
3 Percutaneous
J Synthetic Substitute
K Nonautologous Tissue
Z No Device
3 Sclera Cavity
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Trainer
ALL THINGS CODING®
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complete coding is a
must in today’s
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4. Page 4 Coding Yesterday’s Nomenclature Today
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