July 13, 2014

ICD-10-PCS Character Analysis: Test Your Knowledge of Character 3 – Root Operation or Type

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The process of constructing codes in ICD-10-PCS is designed to be logical and consistent: individual letters and numbers, called "values," are selected in sequence to occupy the seven spaces of the code, called "characters." 

For 10 of the 16 ICD-10-PCS sections, the third character defines the root operation – the objective of the procedure. For the following ancillary sections, the third character defines the procedure by root type: Imaging, Nuclear Medicine, Radiation Therapy, Physical Rehabilitation and Diagnostic Audiology, Mental Health, and Substance Abuse Treatment.

 

 

 

Medical and Surgical root operations include: Alteration, Bypass, Change, Control, Creation, Destruction, Detachment, Dilation, Division, Drainage, Excision, Extraction, Extirpation, Fragmentation, Fusion, Insertion, Inspection, Map, Occlusion, Reattachment, Release, Removal, Repair, Replacement, Reposition, Restriction, Resection, Revision, Supplement, Transfer, and Transplantation.

Obstetrics root operations include: Abortion, Change, Delivery, Drainage, Extraction, Insertion, Inspection, Removal, Repair, Reposition, Resection, and Transplantation.

Administration root operations include: Introduction, Irrigation, and Transfusion.

Measurement and Monitoring root operations include: Measurement and Monitoring.

Extracorporeal Assistance and Performance root operations include: Assistance, Performance, and Restoration.

Extracorporeal Therapies root operations include: Atmospheric Control, Decompression, Electromagnetic Therapy, Hyperthermia, Hypotheramia, Pheresis, Phototherapy, Ultrasound Therapy, Ultraviolet Light Therapy, and Shock Wave Therapy.

The only Osteopathic root operation is: Treatment.

The only Chiropractic root operation is: Manipulation.

Imaging root types include: Computerized Tomography (CT scan), Fluoroscopy, Magnetic Resonance Imaging (MRI), Plain Radiography, and Ultrasonography.

Nuclear Medicine root types include: Nonimaging Nuclear Medicine Assay, Nonimaging Nuclear Medicine Probe, Nonimaging Nuclear Medicine Uptake, Planar Nuclear Medicine, Positron Emission Tomography (PET), Systemic Nuclear Medicine Therapy, and Tomographic Nuclear Medicine Imaging.

Radiation Therapy root types include: Beam Radiation, Brachytherapy, Other Radiation, and Stereotactic Radiosurgery.

Physical Rehabilitation and Diagnostic Audiology root types include: Activities of Daily Living Assessment, Activities of Daily Living Treatment, Caregiver Training, Cochlear Implant Treatment, Device Fitting, Hearing Aid Assessment, Hearing Assessment, Hearing Treatment, Motor and/or Nerve Function Assessment, Motor Treatment, Speech Assessment, Speech Treatment, Vestibular Assessment, and Vestibular Treatment.

Mental Health root types include: Biofeedback, Counseling, Crisis Intervention, Electroconvulsive Therapy, Family Psychotherapy, Group Therapy, Hypnosis, Individual Psychotherapy, Light Therapy, Narcosynthesis, and Psychological Tests.

Substance Abuse root types include: Detoxification Services, Family Counseling, Group Counseling, Individual Counseling, Individual Psychotherapy, Medication Management, and Pharmacotherapy.

For the official definitions of these root operations and types, see the Definitions appendix in ICD-10-PCS. The following is a simple exercise that promotes understanding:

Using the ICD-10-PCS Definitions appendix, answer the following questions (the answer key is provided at the end of the test):

1. Locating the route of passage of electrical impulses and/or locating functional areas in a body part is the definition for:

a. Shock Wave Therapy             b. Map 

2. Completely closing an orifice or the lumen of a tubular body part is the definition for:

a. Occlusion                              b. Restriction

3. Extracorporeal separation of blood products is the definition for:

a. Transfusion                            b. Pheresis

4. Methodologies which attempt to remediate or cure a disorder or disease is the definition for:

a. Repair                                    b. Other Procedures

5. A manual procedure that involves a directed thrust to move a joint past the physiological range of motion without exceeding the anatomical limit is the definition for:

a. Manipulation                           b. Reposition

Using ICD-10-PCS 2014 Index, identify the root operation or root type listed in the index for the following procedures (the answer key is provided at the end of the test)

PROCEDURE

ROOT OPERATION

Adhesiolysis

 

Amnioinfusion

 

Artificial rupture of membranes (AROM)

 

Bililite therapy

 

Bone marrow transplant

 

Cardioversion

 

Catheterization - Heart

 

Chemotherapy, Infusion for cancer

 

Decortication - Lung

 

Endarterectomy

 

Electrophysiologic Stimulation (EPS)

 

Face lift

 

Hemodialysis

 

Loop ileostomy

 

Percutaneous transluminal coronary angioplasty (PTCA)

 

Reduction – Fracture

 

Robotic Assistance

 

Takedown – Stoma

 

Answer key(sources are the ICD-10-PCS 2014 Definitions and Index): 

1. Locating the route of passage of electrical impulses and/or locating functional areas in a body part is the definition for:

a. Shock Wave Therapy             b. Map 

2. Completely closing an orifice or the lumen of a tubular body part is the definition for:

a. Occlusion                              b. Restriction

3. Extracorporeal separation of blood products is the definition for:

a. Transfusion                            b. Pheresis

4. Methodologies which attempt to remediate or cure a disorder or disease is the definition for:

a. Repair                                    b. Other Procedures

5. A manual procedure that involves a directed thrust to move a joint past the physiological range of motion without exceeding the anatomical limit is the definition for:

a. Manipulation                           b. Reposition

PROCEDURE

ROOT OPERATION

Adhesiolysis

Release

Amnioinfusion

Introduction

Artificial rupture of membranes (AROM)

Drainage

Bililite therapy

Ultraviolet Light Therapy

Bone marrow transplant

Transfusion

Cardioversion

Restoration

Catheterization - Heart

Measurement

Chemotherapy, Infusion for cancer

Introduction

Decortication - Lung

Extraction

Endarterectomy

Extirpation

Electrophysiologic Stimulation (EPS)

Measurement

Face lift

Alteration

Hemodialysis

Performance

Loop ileostomy

Bypass

Percutaneous transluminal coronary angioplasty (PTCA)

Dilation

Reduction - Fracture

Reposition

Robotic Assistance

Other Procedures

Takedown - Stoma

Repair

To access the 2014 ICD-10-PCS electronic files, go online to http://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10-PCS.html, then scroll down and download the folder titled “2014 Code Tables and Index.” When you open the folder, you will see the following file: “PCS_2014.” This PDF file is the ICD-10-PCS 2014 Tables and Index.

Lolita M. Jones, RHIA, CCS

Lolita M. Jones, RHIA, CCS, is the principal of Lolita M. Jones Consulting Services (LMJCS), founded in October 1998 in Fort Washington, MD. Ms. Jones has over 25 years of experience in coding and consulting. She started preparing for the implementation of ICD-10-CM/PCS by going back to school. On September 12, 2010, Ms. Jones became an AHIMA-approved ICD-10-CM/PCS trainer.