Excision-Root Operation B Excision is used when a sharp instrument is used to cut out or off a portion of a body part without replacement.
One of the keys to understanding ICD-10-PCS are the many new definitions and descriptions used to describe the various components of a performed procedure. This article focuses on the definitions of four of the root operations-Division, Release, Control, and Repair-in the Medical and Surgical section.
Removal: Root Operation P The root operation Removal is used when the procedure to remove a device is not a component of another root operation. The root operation Removal may be used regardless of the approach or the original root operation by which the device was placed.
The root operation is the third character in the PCS code and describes the intent or the objective of the procedure. The majority of PCS codes reported for the inpatient setting are found in the Medical and Surgical section of ICD-10-PCS. There are 31 root operations in this section.
ICD-10-PCS will be the official system of assigning codes to procedures associated with hospital utilization in the United States. ICD-10-PCS codes will support data collection, payment and electronic health records. ICD-10-PCS is a medical classification coding system for procedural codes.
Example of an ICD-10-PCS code Here is an example of what an ICD-10-PCS code looks like: 047K0ZZ. This is the ICD-10-PCS code for the dilation of a right femoral artery using an open approach.
Root operations that take out some or all of a body part include Excision, Resection, Detachment, Destruction, and Extraction. Root operations that take out solids/fluids/gases from a body part include Drainage, Extirpation, and Fragmentation.
31 root operationsThe medical and surgical procedure section of ICD-10-PCS contains most (but not all) procedures typically coded and reported in the hospital inpatient setting. There are 31 root operations in this section.
Root Operation “Resection” This root operation would be selected when the physician removes all of a body part without replacement. When resection of an organ is completed, no portion of that specific organ is left behind.
Examples: Herniorrhaphy using mesh, free nerve graft, mitral valve ring annuloplasty, put a new acetabular liner in a previous hip replacement. The body part transferred remains connected to its vascular and nervous supply.
If the sole objective of the procedure is separating or transecting a body part, the root operation is Division. Examples: Freeing a nerve root from surrounding scar tissue to relieve pain is coded to the root operation Release. Severing a nerve root to relieve pain is coded to the root operation Division.
Osteopathic: Section Value 7 The Osteopathic section is one of the smallest sections in ICD-10-PCS with only a single body system, Anatomic Regions, and a single root operation, Treatment.
In ICD-9-CM, indexing lithotripsy directs the coder to 51.49, Incision of other bile ducts for relief of obstruction. This code does not identify the use of the scope to accomplish the procedure. Indexing ERCP directs the coder to 51.10, Endoscopic retrograde cholangiopancreatography (ERCP).
Biopsy followed by more definitive treatment: B3.4. If a diagnostic Excision, Extraction, or Drainage procedure (biopsy) is followed by a more definitive procedure, such as Destruction, Excision, or Resection, at the same procedure site, both the biopsy and the more definitive treatment are coded.
It is important to note that fragmentation cannot be coded with extirpation. For additional information, review the procedure coding for an ESWL of the bilateral ureters. This procedure requires two codes, 0TF7XZZ and 0TF6XZZ, as there is not a bilateral body part value for the ureter.