Power up your codingoptum360coding.com
2019
ICD-10-PCS Expert The complete official code set
Codes valid from October 1, 2018 through September 30, 2019
EXPERT
ITPC_ITPCS19_CVR.indd 1 12/4/17 2:18 PM
ICD-10-PCS 2019 i
ContentsPreface ....................................................................................iii
What’s New for 2019 ...............................................................v
Introduction .............................................................................1History of ICD-10-PCS ................................................................................1Number of Codes in ICD-10-PCS ...........................................................2ICD-10-PCS Manual ....................................................................................2Medical and Surgical Section (0) ...........................................................5Obstetrics Section (1) ................................................................................8Placement Section (2) ...............................................................................9Administration Section (3) .....................................................................10Measurement and Monitoring Section (4) ........................................10Extracorporeal or Systemic Assistance and
Performance Section (5) ........................................................11Extracorporeal or Systemic Therapies Section (6) ...........................11Osteopathic Section (7) ..........................................................................12Other Procedures Section (8) ................................................................13Chiropractic Section (9) ..........................................................................13Imaging Section (B) .................................................................................13Nuclear Medicine Section (C) ................................................................14Radiation Therapy Section (D) ..............................................................15Physical Rehabilitation and Diagnostic Audiology Section (F) .....15Mental Health Section (G) ......................................................................16Substance Abuse Treatment Section (H) ...........................................17New Technology Section (X) .................................................................17Appendixes ................................................................................................18
ICD-10-PCS Index and Tabular Format ..................................21Index ............................................................................................................21Code Tables ...............................................................................................21
ICD-10-PCS Additional Features ............................................23Use of Official Sources .............................................................................23Table Notations ........................................................................................23Index Notations ........................................................................................24
ICD-10-PCS Official Guidelines for Coding and Reporting 2019 ...............................................................25
Conventions ..............................................................................................25Medical and Surgical Section Guidelines (section 0) ......................26Obstetric Section Guidelines (section 1) ............................................30New Technology Section Guidelines (section X) ..............................30Selection of Principal Procedure ..........................................................30
ICD-10-PCS Tables ...............................................................125Central Nervous System and Cranial Nerves ................................ 125Peripheral Nervous System ................................................................ 145Heart and Great Vessels ....................................................................... 163Upper Arteries ........................................................................................ 183Lower Arteries ........................................................................................ 205Upper Veins ............................................................................................ 227Lower Veins ............................................................................................ 245Lymphatic and Hemic Systems ......................................................... 263Eye ............................................................................................................ 281Ear, Nose, Sinus ...................................................................................... 299Respiratory System ............................................................................... 319Mouth and Throat ................................................................................. 335Gastrointestinal System ...................................................................... 353Hepatobiliary System and Pancreas ................................................. 381Endocrine System ................................................................................. 395Skin and Breast ...................................................................................... 405Subcutaneous Tissue and Fascia ....................................................... 419Muscles .................................................................................................... 437Tendons ................................................................................................... 459Bursae and Ligaments ......................................................................... 473
Head and Facial Bones ......................................................................... 495Upper Bones ........................................................................................... 515Lower Bones ........................................................................................... 535Upper Joints ........................................................................................... 553Lower Joints ........................................................................................... 571Urinary System ....................................................................................... 593Female Reproductive System ............................................................ 609Male Reproductive System ................................................................. 629Anatomical Regions, General ............................................................. 643Anatomical Regions, Upper Extremities .......................................... 653Anatomical Regions, Lower Extremities .......................................... 663Obstetrics ................................................................................................ 673Placement ............................................................................................... 677Administration ....................................................................................... 683Measurement and Monitoring .......................................................... 697Extracorporeal or Systemic Assistance and Performance ........... 703Extracorporeal or Systemic Therapies ............................................. 705Osteopathic ............................................................................................ 707Other Procedures .................................................................................. 709Chiropractic ............................................................................................ 711Imaging ................................................................................................... 713Nuclear Medicine .................................................................................. 747Radiation Therapy ................................................................................. 759Physical Rehabilitation and Diagnostic Audiology ....................... 775Mental Health ........................................................................................ 791Substance Abuse Treatment .............................................................. 795New Technology ................................................................................... 799
Appendixes ......................................................................... 803Appendix A: Components of the Medical and
Surgical Approach Definitions .........................................803Appendix B: Root Operation Definitions ......................................... 805Appendix C: Comparison of Medical and Surgical
Root Operations .................................................................... 811Appendix D: Body Part Key ................................................................. 813Appendix E: Body Part Definitions .................................................... 829Appendix F: Device Key and Aggregation Table ........................... 841Appendix G: Device Definitions ......................................................... 851Appendix H: Substance Key/Substance Definitions ..................... 857Appendix I: Sections B–H Character Definitions ........................... 859Appendix J: Hospital Acquired Conditions ..................................... 869Appendix K: Coding Exercises and Answers ................................... 899Appendix L: Procedure Combination Tables ................................. 913
Sample
Pag
e
Bypass — continuedVein — continued
Internal Jugular — continuedRight 051M
Intracranial 051LPortal 0618Renal
Left 061BRight 0619
SaphenousLeft 061QRight 061P
Splenic 0611Subclavian
Left 0516Right 0515
Superior Mesenteric 0615Vertebral
Left 051SRight 051R
Vena CavaInferior 0610Superior 021V
VentricleLeft 021LRight 021K
Bypass, cardiopulmonary 5A1221Z
CCaesarean section see Extraction, Products of Concep-
tion 10D0Calcaneocuboid joint
use Tarsal Joint, Leftuse Tarsal Joint, Right
Calcaneocuboid ligamentuse Foot Bursa and Ligament, Leftuse Foot Bursa and Ligament, Right
Calcaneofibular ligamentuse Ankle Bursa and Ligament, Leftuse Ankle Bursa and Ligament, Right
Calcaneususe Tarsal, Leftuse Tarsal, Right
Cannulationsee Bypasssee Dilationsee Drainagesee Irrigation
Canthorrhaphy see Repair, Eye 08QCanthotomy see Release, Eye 08NCapitate bone
use Carpal, Leftuse Carpal, Right
Capsulectomy, lens see Excision, Eye 08BCapsulorrhaphy, joint
see Repair, Lower Joints 0SQsee Repair, Upper Joints 0RQ
Cardia use Esophagogastric JunctionCardiac contractility modulation lead use Cardiac
Lead in Heart and Great VesselsCardiac event recorder use Monitoring DeviceCardiac Lead
DefibrillatorAtrium
Left 02H7Right 02H6
Pericardium 02HNVein, Coronary 02H4Ventricle
Left 02HLRight 02HK
Insertion of device inAtrium
Left 02H7Right 02H6
Pericardium 02HNVein, Coronary 02H4Ventricle
Left 02HLRight 02HK
PacemakerAtrium
Left 02H7Right 02H6
Pericardium 02HNVein, Coronary 02H4
Cardiac Lead — continuedPacemaker — continued
VentricleLeft 02HLRight 02HK
Removal of device from, Heart 02PARevision of device in, Heart 02WA
Cardiac plexus use Thoracic Sympathetic NerveCardiac Resynchronization Defibrillator Pulse Gen-
eratorAbdomen 0JH8Chest 0JH6
Cardiac Resynchronization Pacemaker Pulse Gener-ator
Abdomen 0JH8Chest 0JH6
Cardiac resynchronization therapy (CRT) leaduse Cardiac Lead, Defibrillator in 02Huse Cardiac Lead, Pacemaker in 02H
Cardiac Rhythm Related DeviceInsertion of device in
Abdomen 0JH8Chest 0JH6
Removal of device from, Subcutaneous Tissue andFascia, Trunk 0JPT
Revision of device in, Subcutaneous Tissue and Fascia,Trunk 0JWT
Cardiocentesis see Drainage, Pericardial Cavity 0W9DCardioesophageal junction use Esophagogastric
JunctionCardiolysis see Release, Heart and Great Vessels 02NCardioMEMS® pressure sensoruseMonitoring Device,
Pressure Sensor in 02HCardiomyotomy seeDivision, Esophagogastric Junction
0D84Cardioplegia see Introduction of substance in or on,
Heart 3E08Cardiorrhaphy see Repair, Heart and Great Vessels 02QCardioversion 5A2204ZCaregiver Training F0FZCaroticotympanic artery
use Internal Carotid Artery, Leftuse Internal Carotid Artery, Right
Carotid glomususe Carotid Bodies, Bilateraluse Carotid Body, Leftuse Carotid Body, Right
Carotid sinususe Internal Carotid Artery, Leftuse Internal Carotid Artery, Right
Carotid (artery) sinus (baroreceptor) lead use Stimu-lator Lead in Upper Arteries
Carotid sinus nerve use Glossopharyngeal NerveCarotid WALLSTENT® Monorail® Endoprosthesisuse
Intraluminal DeviceCarpectomy
see Excision, Upper Bones 0PBsee Resection, Upper Bones 0PT
Carpometacarpal ligamentuse Hand Bursa and Ligament, Leftuse Hand Bursa and Ligament, Right
Casting see ImmobilizationCAT scan see Computerized Tomography (CT Scan)Catheterization
see Dilationsee Drainagesee Insertion of device insee IrrigationHeart see Measurement, Cardiac 4A02Umbilical vein, for infusion 06H033T
Cauda equina use Spinal Cord, LumbarCauterization
see Destructionsee Repair
Cavernous plexususeHead and Neck Sympathetic NerveCBMA (Concentrated Bone Marrow Aspirate) use
Concentrated Bone Marrow AspirateCBMA (Concentrated Bone Marrow Aspirate) injec-
tion, intramuscular XK02303Cecectomy
see Excision, Cecum 0DBHsee Resection, Cecum 0DTH
Cecocolostomysee Bypass, Gastrointestinal System 0D1see Drainage, Gastrointestinal System 0D9
Cecopexysee Repair, Cecum 0DQH
Cecopexy — continuedsee Reposition, Cecum 0DSH
Cecoplication see Restriction, Cecum 0DVHCecorrhaphy see Repair, Cecum 0DQHCecostomy
see Bypass, Cecum 0D1Hsee Drainage, Cecum 0D9H
Cecotomy see Drainage, Cecum 0D9HCeftazidime-Avibactam Anti-infective XW0Celiac ganglion use Abdominal Sympathetic NerveCeliac lymph node use Lymphatic, AorticCeliac (solar) plexususeAbdominal Sympathetic NerveCeliac trunk use Celiac ArteryCentral axillary lymph node
use Lymphatic, Left Axillaryuse Lymphatic, Right Axillary
Central venous pressure see Measurement, Venous4A04
Centrimag® Blood Pumpuse Short-term External HeartAssist System in Heart and Great Vessels
Cephalogram BN00ZZZCeramic on ceramic bearing surface use Synthetic
Substitute, Ceramic in 0SRCerclage see RestrictionCerebral aqueduct (Sylvius) use Cerebral VentricleCerebral Embolic Filtration, Dual Filter X2A5312Cerebrum use BrainCervical esophagus use Esophagus, UpperCervical facet joint
use Cervical Vertebral Jointuse Cervical Vertebral Joint, 2 or more
Cervical ganglionuseHead and Neck Sympathetic NerveCervical interspinous ligament use Bursa and Liga-
ment, Head and NeckCervical intertransverse ligamentuseBursa and Liga-
ment, Head and NeckCervical ligamentum flavum use Bursa and Ligament,
Head and NeckCervical lymph node
use Lymphatic, Left Neckuse Lymphatic, Right Neck
Cervicectomysee Excision, Cervix 0UBCsee Resection, Cervix 0UTC
Cervicothoracic facet joint use Cervicothoracic Verte-bral Joint
Cesarean section seeExtraction, Products of Conception10D0
Cesium-131 Collagen ImplantuseRadioactive Element,Cesium-131 Collagen Implant in 00H
Change device inAbdominal Wall 0W2FXBack
Lower 0W2LXUpper 0W2KX
Bladder 0T2BXBone
Facial 0N2WXLower 0Q2YXNasal 0N2BXUpper 0P2YX
Bone Marrow 072TXBrain 0020XBreast
Left 0H2UXRight 0H2TX
Bursa and LigamentLower 0M2YXUpper 0M2XX
Cavity, Cranial 0W21XChest Wall 0W28XCisterna Chyli 072LXDiaphragm 0B2TXDuct
Hepatobiliary 0F2BXPancreatic 0F2DX
EarLeft 092JXRight 092HX
Epididymis and Spermatic Cord 0V2MXExtremity
LowerLeft 0Y2BXRight 0Y29X
UpperLeft 0X27XRight 0X26X
2 Subterms under main terms may continue to next column or page36
ICD-10-PCS 2019BypassIn
dex
Bypa
ss—
Cha
nge
devi
ce in
Sample
Pag
e
Central Nervous System
and Cranial Nerves
ICD-10-PCS 2019 125
ICD-10-PCS Tables
Central Nervous System and Cranial Nerves 001–00XCharacter Meanings This Character Meaning table is provided as a guide to assist the user in the identification of character members that may be found in this section of code tables. It SHOULD NOT be used to build a PCS code.
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,
Cesium-131 Collagen Implant
3 Blood Vessel
8 Division 4 Subdural Space, Intracranial
7 Autologous Tissue Substitute
4 Pleural Cavity
9 Drainage 5 Subarachnoid Space, Intracranial
J Synthetic Substitute 5 Intestine
B Excision 6 Cerebral Ventricle K Nonautologous Tissue Substitute
6 Peritoneal Cavity
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 K Map C Cerebellum G Optic Nerve N Release D Medulla Oblongata H Oculomotor Nerve P Removal E Cranial Nerve J Trochlear Nerve Q Repair F Olfactory Nerve K Trigeminal Nerve R Replacement G Optic Nerve L Abducens Nerve S Reposition H Oculomotor Nerve M Facial Nerve T Resection J Trochlear Nerve N Acoustic Nerve U Supplement K Trigeminal Nerve P Glossopharyngeal Nerve W Revision L Abducens Nerve Q Vagus NerveX Transfer M Facial Nerve R Accessory Nerve
N Acoustic Nerve S Hypoglossal Nerve P Glossopharyngeal Nerve X Diagnostic Q Vagus Nerve Z No Qualifier R Accessory Nerve S Hypoglossal Nerve T Spinal Meninges U Spinal Canal V Spinal Cord W Cervical Spinal Cord X Thoracic Spinal Cord Y Lumbar Spinal Cord Sam
ple P
age
001–002 Central Nervous System and Cranial Nerves ICD-10-PCS 2019
3 Limited Coverage 4 Noncovered ? Combination Member HAC associated procedure Combination Only DRG Non-OR Non-OR New/Revised in GREEN 128 ICD-10-PCS 2019
001–
002
Cent
ral N
ervo
us S
yste
m a
nd C
rani
al N
erve
s
0 Medical and Surgical0 Central Nervous System and Cranial Nerves 0011 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.
Body PartCharacter 4
ApproachCharacter 5
DeviceCharacter 6
QualifierCharacter 7
6 Cerebral VentricleAqueduct of SylviusCerebral aqueduct (Sylvius)Choroid plexusEpendymaForamen of Monro (intraventricular)Fourth ventricle Interventricular foramen (Monro) Left lateral ventricleRight lateral ventricleThird ventricle
0 Open3 Percutaneous4 Percutaneous Endoscopic
7 Autologous Tissue Substitute
J Synthetic SubstituteK Nonautologous Tissue
Substitute
0 Nasopharynx1 Mastoid Sinus2 Atrium3 Blood Vessel4 Pleural Cavity5 Intestine6 Peritoneal Cavity7 Urinary Tract8 Bone MarrowB Cerebral Cisterns
6 Cerebral VentricleAqueduct of SylviusCerebral aqueduct (Sylvius)Choroid plexusEpendymaForamen of Monro (intraventricular)Fourth ventricle Interventricular foramen (Monro) Left lateral ventricleRight lateral ventricleThird ventricle
0 Open3 Percutaneous4 Percutaneous Endoscopic
Z No Device B Cerebral Cisterns
U Spinal CanalEpidural space, spinalExtradural space, spinalSubarachnoid space, spinalSubdural space, spinalVertebral canal
0 Open3 Percutaneous
7 Autologous Tissue Substitute
J Synthetic SubstituteK Nonautologous Tissue
Substitute
4 Pleural Cavity6 Peritoneal Cavity7 Urinary Tract9 Fallopian Tube
0 Medical and Surgical0 Central Nervous System and Cranial Nerves 0022 Change Definition: Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without
cutting or puncturing the skin or a mucous membraneExplanation: All CHANGE procedures are coded using the approach EXTERNAL
Body PartCharacter 4
ApproachCharacter 5
DeviceCharacter 6
QualifierCharacter 7
0 BrainCerebrumCorpus callosum Encephalon
E Cranial NerveU Spinal Canal
Epidural space, spinalExtradural space, spinalSubarachnoid space, spinalSubdural space, spinalVertebral canal
X External 0 Drainage DeviceY Other Device
Z No Qualifier
Non-OR All body part, approach, device, and qualifier valuesSample
Pag
e
02H–02H Heart and Great Vessels ICD-10-PCS 2019
3 Limited Coverage 4 Noncovered ? Combination Member HAC associated procedure Combination Only DRG Non-OR Non-OR New/Revised in GREEN172 ICD-10-PCS 2018
02H
–02H
Hea
rt a
nd G
reat
Ves
sels
0 Medical and Surgical2 Heart and Great Vessels 02HH 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 partExplanation: None
Body PartCharacter 4
ApproachCharacter 5
DeviceCharacter 6
QualifierCharacter 7
4 Coronary Vein ?6 Atrium, Right ?
Atrium dextrum cordisRight auricular appendixSinus venosus
7 Atrium, Left ?Atrium pulmonaleLeft auricular appendix
K Ventricle, Right ?Conus arteriosus
L Ventricle, Left ?
0 Open 3 Percutaneous4 Percutaneous Endoscopic
0 Monitoring Device, Pressure Sensor2 Monitoring Device 3 Infusion Device D Intraluminal Device J Cardiac Lead, PacemakerK Cardiac Lead, DefibrillatorM Cardiac Lead N Intracardiac PacemakerY Other Device
Z No Qualifier
A Heart 34 0 Open3 Percutaneous4 Percutaneous Endoscopic
Q Implantable Heart Assist SystemY Other Device
Z No Qualifier
A Heart ? 0 Open3 Percutaneous4 Percutaneous Endoscopic
R Short-term External Heart Assist System
J IntraoperativeS BiventricularZ No Qualifier
N Pericardium ? 0 Open 3 Percutaneous 4 Percutaneous Endoscopic
0 Monitoring Device, Pressure Sensor2 Monitoring DeviceJ Cardiac Lead, Pacemaker K Cardiac Lead, DefibrillatorM Cardiac Lead Y Other Device
Z No Qualifier
P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left
Arterial canal (duct)Botallo's ductPulmoaortic canal
S Pulmonary Vein, Right Right inferior pulmonary veinRight superior pulmonary vein
T Pulmonary Vein, Left Left inferior pulmonary veinLeft superior pulmonary vein
V Superior Vena Cava Precava
W Thoracic Aorta, Descending
0 Open 3 Percutaneous 4 Percutaneous Endoscopic
0 Monitoring Device, Pressure Sensor2 Monitoring Device3 Infusion Device D Intraluminal DeviceY Other Device
Z No Qualifier
X Thoracic Aorta, Ascending/ArchAortic archAscending aorta
0 Open 3 Percutaneous 4 Percutaneous Endoscopic
0 Monitoring Device, Pressure Sensor2 Monitoring Device3 Infusion Device D Intraluminal Device
Z No Qualifier
DRG Non-OR 02H[4,6,7][0,4][J,M]ZDRG Non-OR 02H[6,7]3JZDRG Non-OR 02H[K,L][0,3,4][J,M]ZDRG Non-OR 02HK32ZDRG Non-OR 02HN32ZNon-OR 02H[4,6,7,L]3[2,3,D]ZNon-OR 02HK3[3,D]ZNon-OR 02H[4,6,7,K,L][3,4]YZNon-OR 02HA[3,4]YZNon-OR 02HN[3,4]YZNon-OR 02HP[0,3,4][0,2,3,Y]ZNon-OR 02HP3DZNon-OR 02H[Q,R][0,3,4][2,3]ZNon-OR 02H[Q,R]3DZNon-OR 02H[Q,R][3,4]YZNon-OR 02H[S,T,V][0,4]3ZNon-OR 02H[S,T,V]3[2,3,D]ZNon-OR 02H[S,T,V][3,4]YZNon-OR 02HW[0,4][0,3]ZNon-OR 02HW3[0,2,3,D]ZNon-OR 02HW[0,3,4]YZNon-OR 02HX[0,3,4][0,3]Z
HAC 02H43[J,K,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA or T82.7XXA
HAC 02H[6,K]33Z when reported with SDx J95.811HAC 02H[6,7]3[J,M]Z when reported with SDx K68.11 or T81.4XXA or T82.6XXA
or T82.7XXAHAC 02H[K,L]3JZ when reported with SDx K68.11 or T81.4XXA or T82.6XXA or
T82.7XXAHAC 02HN[0,3,4][J,M]Z when reported with SDx K68.11 or T81.4XXA or
T82.6XXA or T82.7XXAHAC 02H[S,T,V][3,4]3Z when reported with SDx J95.8113 02HA0QZ4 02HA[3,4]QZ
See Appendix L for Procedure Combinations? 02H[4,6,7,K,L][0,3,4]KZ? 02H43[J,M]Z? 02HA[0,4]R[S,Z]? 02HA3RS? 02HN[0,3,4][J,K,M]Z
ICD-10-PCS 2019 Upper Arteries Up
per Arteries
ICD-10-PCS 2019 185
Upper Arteries
Head and Neck Arteries
Common carotid H,JVertebral P,Q
External carotid M,N
Internal carotid K,L
Ophthalmic G
Basilar G
Anterior cerebral G Middle cerebral G
Posterior cerebral G
Anterior communicating GPosterior communicating G
Sample
Pag
e