May 15, 2012

ICD-10-PCS Table 4A0: Cardiac Catheterization and Other Measurements

The ICD-10-PCS root operation Table 4A0 classifies procedures and tests that involve measurement, which is defined in ICD-10-PCS as determining the level of a physiological or physical function at a certain point in time.

An ICD-10-PCS code is derived by choosing a specific value for each of the seven characters in the root operation table. Coding specialists must be cautious, however, because the same value placed in a different position in the code would denote something entirely different (i.e. the value “3” in the first character means something different than “3” in the second character or “3” in the third character, and so on). Each character in the seven-character code represents an aspect of a procedure, as shown in the ICD-10-PCS Table 4A0, which is provided below:

DOWNLOAD ICD-10-PCS Table 4A0 & CODES PDF

ICD-10-PCS Implementation Exercise: Audit the Documentation found in “Measurement” Reports:

Generate a report citing all 2011 inpatient cases that contain any of the “measurement” ICD-9-CM procedure codes listed above. The report’s data elements should include, at minimum, patient account numbers, discharge dates, the “measurement” ICD-9-CM procedure codes and surgeon names/ID numbers.

Review each operative report or diagnostic study report assigned to a “measurement” ICD-9-CM procedure code and try to re-code the report in ICD-10-PCS (a sample of reports can be used for the high-volume “measurement” services).

Document the ICD-10-PCS code assigned to each report, and when appropriate include any comments on why the case could not be coded in ICD-10-PCS (i.e. insufficient documentation).
Use the audit findings to educate physicians and other clinicians on the additional level of documentation that will be needed for timely and accurate coding of measurement procedures and tests under ICD-10-PCS.

References:

In order to access the 2012 ICD-10-PCS mapping files, go online to

http://www.cms.gov/Medicare/Coding/ICD10/2012-ICD-10-PCS.html.

Under the “Downloads” subheading, scroll down and download the folder titled 2012 Mapping - "ICD-10-PCS to ICD-9-CM" and "ICD-9-CM to ICD-10-PCS"; and User Guide, Reimbursement Guide - Procedures [ZIP, 827KB]

Once the folder is open, you will find several files; you will need the following file to view the ICD-9-CM procedure codes that are mapped to the ICD-10-PCS Table 4A0:

“gem_pcsi9” – This file lists the ICD-10-PCS codes in the first column and the ICD-9-CM procedure codes in the second column.

In order to access the 2012 ICD-10-PCS code book electronic files, go online to http://www.cms.gov/Medicare/Coding/ICD10/2012-ICD-10-PCS.html.

Under the “Downloads” subheading, scroll down and download the folder titled 2012 Code Tables and Index [ZIP, 4MB]

Once the folder is open, you will find several files; you will need the following file:

“pcs_2012.pdf” – This is the ICD-10-PCS index and root operation tables.

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.