ICD-10-PCS (International Classification of Diseases, Tenth Revision, Procedure Coding System) is a medical classification system used to code procedures and services performed in healthcare facilities. It was developed by the Centers for Medicare and Medicaid Services (CMS) in the United States and is used by healthcare providers to communicate and bill for medical services.
ICD-10-PCS is composed of codes that describe medical procedures, such as surgeries, imaging, and diagnostic tests. These codes are organized into tables based on body systems, such as respiratory, cardiovascular, and musculoskeletal. Each code is seven characters long and is composed of alpha-numeric characters that represent specific details about the procedure being performed.
There are 17 sections in the ICD-10-PCS code set, each corresponding to a specific type of medical procedure. These sections include:
- Medical and Surgical
- Obstetrics
- Placement
- Administration
- Measurement and Monitoring
- Extracorporeal Assistance and Performance
- Osteopathic
- Chiropractic
- Other Procedures B. Imaging C. Nuclear Medicine D. Radiation Therapy F. Mental Health G. Substance Abuse Treatment H. Rehabilitation K. Medical and Surgical Supplies and Devices Z. New Technology
Within each section, codes are further broken down into tables based on the body system or anatomical location. For example, the Medical and Surgical section includes tables for the respiratory, digestive, and cardiovascular systems, among others.
ICD-10-PCS codes are used by healthcare providers to communicate with insurance companies and government programs, such as Medicare and Medicaid, to bill for medical procedures. These codes are also used for data collection and analysis, research, and quality improvement initiatives in healthcare.
It is important for healthcare providers to accurately code medical procedures using ICD-10-PCS codes, as incorrect or incomplete coding can lead to billing errors, denied claims, and potential financial losses for the healthcare facility. Additionally, accurate coding helps ensure that patient data is collected and analyzed appropriately, which can improve patient outcomes and inform healthcare policy decisions.