ICD-10-PCS The Complete Official Code Set. Sample

Transcription

1 ICD-10-PCS The Complete Official Code Set 2017

2 Heart and Great Vessels Heart and Great Vessels ICD-10-PCS Heart and Great Vessels Bypass Definition: Altering the route of passage of the contents of a tubular body part Explanation: Rerouting contents of a body part to a downstream area of the normal route, to a similar route and body part, or to an abnormal route and dissimilar body part. Includes one or more anastomoses, with or without the use of a device. 7 Atrium, Left? K L K L Ventricle, Right Ventricle, Left Ventricle, Right Ventricle, Left Non-OR 021[0,1,2,3,]3[4,D]4 Non-OR 021[0,1,2,3]4[4,D]4 021[0,1,2,3]0[9,A,J,K][3,8,9,C,F,W] when reported with SDx J [0,1,2,3]0Z[3,8,9,C,F] when reported with SDx J [0,1,2,3]4[9,A,J,K][3,8,9,C,F,W] when reported with SDx J [0,1,2,3]4Z[3,8,9,C,F] when reported with SDx J Autologous Venous Tissue A Autologous Arterial Tissue 3 Coronary Artery W Aorta Z No 3 Coronary Artery 4 Intraluminal, Drug-eluting D Intraluminal 4 Intraluminal, Drug-eluting D Intraluminal 9 Autologous Venous Tissue A Autologous Arterial Tissue 3 Coronary Artery W Aorta Z No 3 Coronary Artery 9 Autologous Venous Tissue A Autologous Arterial Tissue Z No 7 Atrium, Left 9 Autologous Venous Tissue A Autologous Arterial Tissue Z No 9 Autologous Venous Tissue A Autologous Arterial Tissue Z No 5 Coronary Circulation W Aorta 021 Continued on next page No Procedure Combinations Specified? 02170Z[P,Q,R] 164 ICD-10-PCS 2017

3 ICD-10-PCS 2017 Heart and Great Vessels Continued 2 Heart and Great Vessels Bypass Definition: Altering the route of passage of the contents of a tubular body part Explanation: Rerouting contents of a body part to a downstream area of the normal route, to a similar route and body part, or to an abnormal route and dissimilar body part. Includes one or more anastomoses, with or without the use of a device. W Thoracic Aorta 9 Autologous Venous Tissue A Autologous Arterial Tissue Z No 2 Heart and Great Vessels Destruction Definition: Physical eradication of all or a portion of a body part by the direct use of energy, force, or a destructive agent Explanation: None of the body part is physically taken out L Ventricle, Left 5 Atrial Septum M Ventricular Septum Interatrial septum Interventricular septum N Pericardium 8 Conduction Mechanism Arterial canal (duct) Atrioventricular node Bundle of His Bundle of Kent S Pulmonary Vein, Right Sinoatrial node Right inferior pulmonary 9 Chordae Tendineae D Papillary Muscle Right superior pulmonary F Aortic Valve Aortic annulus T Pulmonary Vein, Left G Mitral Valve Left inferior pulmonary Bicuspid valve Left superior pulmonary Left atrioventricular valve Mitral annulus H Pulmonary Valve Pulmonary annulus J K Pulmonic valve Tricuspid Valve Right atrioventricular valve Tricuspid annulus Ventricle, Right 7 Atrium, Left DRG Non-OR 0257[0,3,4]ZK Subclavian Carotid Pulmonary Trunk Pulmonary Artery, Right Pulmonary Artery, Left ICD-10-PCS B D P Q R Z No Z No Z No K Left Atrial Appendage Z No Heart and Great Vessels

4 ICD-10-PCS 2017 Heart and Great Vessels 02B 02C 2 Heart and Great Vessels 02B B Excision Definition: Cutting out or off, without replacement, a portion of a body part Explanation: The qualifier DIAGNOSTIC is used to identify excision procedures that are biopsies 5 Atrial Septum Interatrial septum 8 Conduction Mechanism Atrioventricular node Bundle of His Bundle of Kent Sinoatrial node 9 Chordae Tendineae D Papillary Muscle F Aortic Valve Aortic annulus G Mitral Valve Bicuspid valve Left atrioventricular valve Mitral annulus H Pulmonary Valve Pulmonary annulus Pulmonic valve J Tricuspid Valve Right atrioventricular valve Tricuspid annulus 7 Atrium, Left K Ventricle, Right?4 L Ventricle, Left 4 M Ventricular Septum Interventricular septum N Pericardium Arterial canal (duct) S T Pulmonary Vein, Right Right inferior pulmonary Right superior pulmonary Pulmonary Vein, Left Left inferior pulmonary Left superior pulmonary DRG Non-OR 02B7[0,3,4]ZK Non-OR 02B[4,5,6,7,8,9,D,F,G,H,J,K,L,M][0,3,4]ZX 4 02BK[0,3,4]ZZ 4 02BL[0,3,4]ZZ Z No X Diagnostic Z No Z No K Left Atrial Appendage X Diagnostic Z No No Procedure Combinations Specified? 02BK0ZZ 2 Heart and Great Vessels 02C C Extirpation Definition: Taking or cutting out solid matter from a body part Explanation: The solid matter may be an abnormal byproduct of a biological function or a foreign body; it may be imbedded in a body part or in the lumen of a tubular body part. The solid matter may or may not have been previously broken into pieces. 2 Coronary Artery, Three Sites 3 Coronary Artery, Four or More Sites 5 Atrial Septum Interatrial septum 7 Atrium, Left 8 Conduction Mechanism Atrioventricular node Bundle of His Bundle of Kent Sinoatrial node 9 Chordae Tendineae D Papillary Muscle F Aortic Valve Aortic annulus G Mitral Valve Bicuspid valve Left atrioventricular valve Mitral annulus H Pulmonary Valve Pulmonary annulus Pulmonic valve J Tricuspid Valve Right atrioventricular valve Tricuspid annulus K Ventricle, Right L Ventricle, Left M Ventricular Septum Interventricular septum N Pericardium Arterial canal (duct) S Pulmonary Vein, Right Right inferior pulmonary Right superior pulmonary T Pulmonary Vein, Left Left inferior pulmonary Left superior pulmonary Z No Z No ICD-10-PCS Heart and Great Vessels 02B 02C

5 02F 02H Heart and Great Vessels 02F 02H Heart and Great Vessels ICD-10-PCS Heart and Great Vessels 02F F Fragmentation Definition: Breaking solid matter in a body part into pieces Explanation: Physical force (e.g., manual, ultrasonic) applied directly or indirectly is used to break the solid matter into pieces. The solid matter may be an abnormal byproduct of a biological function or a foreign body. The pieces of solid matter are not taken out. N Pericardium 4 X External Non-OR 02FNXZZ 4 02FNXZZ Z No Z No 2 Heart and Great Vessels 02H 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?? 7 Atrium, Left? K Ventricle, Right? L Ventricle, Left? A Heart 3 A Heart? N Pericardium? 0 Monitoring, Pressure Sensor 2 Monitoring 3 Infusion D Intraluminal J Cardiac Lead, Pacemaker K Cardiac Lead, Defibrillator M Cardiac Lead Z No Q Implantable Heart Assist System Z No R External Heart Assist System S Biventricular Z No 0 Monitoring, Pressure Sensor Z No 2 Monitoring J Cardiac Lead, Pacemaker K Cardiac Lead, Defibrillator M Cardiac Lead 0 Monitoring, Pressure Sensor Z No 2 Monitoring 3 Infusion Arterial canal (duct) D Intraluminal S Pulmonary Vein, Right Right inferior pulmonary Right superior pulmonary T Pulmonary Vein, Left Left inferior pulmonary Left superior pulmonary DRG Non-OR 02H[4,6,7][0,4][J,M]Z See Appendix I for Procedure Combinations DRG Non-OR 02H[6,7]3J Combo-only 02H[4,6,7,K,L][0,4][J,M]Z DRG Non-OR 02H[K,L][0,3,4][J,M]Z Combo-only 02H[K,L]3MZ Non-OR 02H[P,Q,R][0,3,4][0,2,3]Z? 02H[4,6,7]3[J,M]Z Non-OR 02H[S,T,V][0,3,4]3Z? 02H[K,L]3JZ Non-OR 02HW[0,3,4][0,3]Z? 02H[4,6,7,L][0,3,4]KZ 02H43[J,K,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA? 02HK[0,3,4][0,2,K]Z 02H[6,7]3[J,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA? 02HA[0,4]R[S,Z] 02H[K,L]3JZ when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA? 02HA3RS 02HN[0,3,4][J,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA? 02HN[0,3,4][J,K,M]Z 3 02HA[0,3,4]QZ 168 ICD-10-PCS 2017

6 Appendix L: Procedure Combination Tables Appendix L: Procedure Combination Tables ICD-10-PCS 2017 Appendix L: Procedure Combination Tables The tables below were developed to help simplify the relationship between ICD-10-PCS coding and MS-DRG assignment. The Centers for Medicare & Medicaid Services (CMS) has identified in the MS-DRG v32 Definitions Manual certain procedure combinations that must occur in order to assign a specific MS-DRG. There are many factors influencing MS-DRG assignment, including principal and secondary diagnoses, MCC or CC use, sex of the patient, and discharge status. These tables should be used only as a guide. Note: In some cases the Combination Only and Combination Member codes are not identified as having any other procedures that, when coded together, would influence the MS-DRG assignment. These codes are listed under a footnote titled No Procedure Combinations Specified directly under the table in which the code is found. DRG Heart Transplant or Implant of Heart Assist System Insertion With Removal of Heart Assist System External Type of Heart Assist System Revision With Removal of Heart Assist System Type of Heart Assist System DRG 008 Simultaneous Pancreas/Kidney Transplant DRG Craniotomy Code as appropriate Insertion by approach 02HA[0,4]R[S,Z] or 02HA3RS Code as appropriate Revision by approach Code also as appropriate Removal of Heart Assist System by approach 02PA[0,3,4]RZ Code also as appropriate Removal of Heart Assist System by approach Implantable 02WA[0,3,4]QZ 02PA[0,3,4]RZ External 02WA[0,3,4]RZ 02PA[0,3,4]RZ Transplanted Laterality Code Transplant as appropriate by tissue type Code also Pancreas Transplant as appropriate by tissue type Allogeneic Syngeneic Zooplastic Allogeneic Syngeneic Zooplastic Kidney, Right 0TY00Z0 0TY00Z1 0TY00Z2 0FYG0Z0 0FYG0Z1 0FYG0Z2 Kidney, Left 0TY10Z0 0TY10Z1 0TY10Z2 0FYG0Z0 0FYG0Z1 0FYG0Z2 Site of Neurostimulator Lead Code as appropriate Insertion of Lead by approach Neuro-stimulator Generator Code also as appropriate Insertion of by type and subcutaneous site Stimulator Multiple Array Code as appropriate by approach Stimulator Multiple Array, Rechargeable Code as appropriate by approach Skull Chest Back Abdomen Chest Back Abdomen Brain 00H0[0,3,4]MZ 0NH00NZ 0JH6[0,3]DZ 0JH7[0,3]DZ 0JH8[0,3]DZ 0JH6[0,3]EZ 0JH7[0,3]EZ 0JH8[0,3]EZ Cerebral Ventricle 00H6[0,3,4]MZ 0NH00NZ 0JH6[0,3]DZ 0JH7[0,3]DZ 0JH8[0,3]DZ 0JH6[0,3]EZ 0JH7[0,3]EZ 0JH8[0,3]EZ DRG Spinal Procedures Generator Type Insertion of Generator by Site Code also as appropriate Insertion of Neurostimulator Lead by approach Chest Abdomen Back Spinal Canal Spinal Cord Single Array 0JH6[0,3]BZ 0JH8[0,3]BZ 0JH7[0,3]BZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ Single Array, Rechargeable 0JH6[0,3]CZ 0JH8[0,3]CZ 0JH7[0,3]CZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ Multiple Array 0JH6[0,3]DZ 0JH8[0,3]DZ 0JH7[0,3]DZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ Multiple Array, Rechargeable 0JH6[0,3]EZ 0JH8[0,3]EZ 0JH7[0,3]EZ 00HU[0,3,4]MZ 00HV[0,3,4]MZ 758 ICD-10-PCS 2017

7 ICD-10-PCS 2017 Internal thoracic a.(mammary) Celiac trunk (artery) R. gastric a. Arteries Superficial temporal a. External carotid a. Internal carotid a. Common carotid a. Superior thyroid a. Vertebral a. Inferior thyroid a. Subclavian a. Innominate a. Arch of aorta Brachial a. Common hepatic a. R. colic a. Radial a. Ulnar a. Middle temporal a. Transverse facial a. Femoral a. Popliteal a. Pulmonary a. Axillary a. Descending aorta L. gastric a. Splenic a. Renal a. Superior mesenteric a. Abdominal aorta L. colic a. Inferior mesenteric a. Common iliac a. Internal iliac a. External iliac a. Uterine a. Appendix M: Illustrations Appendix M: Illustrations Anterior tibial a. Peroneal a. Posterior tibial a. ICD-10-PCS