December 8, 2014

Test Your PCS Knowledge of Character 6 – Device

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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." 

In ICD-10-PCS sections 0 through 2, and 4,the sixth character defines the device– i.e., the graft, prosthesis, implant, or appliance (simple, mechanical, or electronic) that was left in place at the end of the procedure. 

 

 

For the following ICD-10-PCS sections Character 6 classifies the following:

  • section 3 (Administration) – substance
  • section 5 (Extracorporeal Assistance and Performance) – function
  • section 6 (Extracorporeal Therapies) – qualifier
  • section 7 (Osteopathic) – method
  • section 8 (Other Procedures) – method
  • section B (Imaging) – qualifier
  • section C (Nuclear Medicine) – qualifier
  • section D (Radiation Therapy) – isotope
  • section F (Physical Rehabilitation and Diagnostic Audiology) – equipment
  • section G (Mental Health) – qualifier
  • section H (Substance Abuse Treatment) – qualifier.

Device Key

An exhaustive list of devices is not possible in the ICD-10-PCS root operation tables, so a Device Key appendix is included in ICD-10-PCS, and it is used to select the appropriate device values for grafts, prostheses, implants, and appliances not listed in the root operation tables.

Below is an excerpt from the Device Key.  The device listed in the left column is not provided in any of the root operation tables, so it is classified to the device value listed in the right column. 

 

Polypropylene mesh

Use:

Synthetic Substitute

Porcine (bioprosthetic) valve

Zooplastic Tissue in Heart and Great Vessels

PRESTIGE® Cervical Disc

Synthetic Substitute

PrimeAdvanced neurostimulator

 

Stimulator Generator, Multiple Array for Insertion in Subcutaneous Tissue and Fascia

Official Device Guidelines

The following are device-specific guidelines that appear in the ICD-10-PCS Official Guidelines for Coding and Reporting:

  • A device is coded only if a device remains after the procedure is completed. If no device remains, the device value No Device is coded (ICD-10-PCS Official Guideline B6.1a).
  • Materials such as sutures, ligatures, radiological markers, and temporary post-operative wound drains are considered integral to the performance of a procedure and are not coded as devices (ICD-10-PCS Official Guideline B6.1b).
  • Procedures performed on a device only and not on a body part are specified in the root operations Change, Irrigation, Removal, and Revision, and are coded to the procedure performed (ICD-10-PCS Official Guideline B6.1c).

Example: Irrigation of percutaneous nephrostomy tube is coded to the root operation Irrigation of indwelling device in the Administration section.

  • A separate procedure to put in a drainage device is coded to the root operation Drainage with the device value Drainage Device (ICD-10-PCS Official Guideline B6.2).

Exercises

Using the Device Key,identify the device value for each of the following appliances, grafts, implants, or prostheses (the Answer Key appears at the end of this article):

Appliance, Graft, Implant, or Prosthesis

ICD-10-PCS Device Value

Autograft

Autologous Tissue Substitute

Bone bank bone graft

 

Bovine pericardial valve

 

Brachytherapy seeds

 

Embolization coil(s)

 

Implanted (venous)(access) port

 

Peripherally inserted central catheter (PICC)

 

PRESTIGE® Cervical Disc

 

Tissue bank graft

 

Total artificial (replacement) heart

 

*To access the 2014 ICD-10-PCS electronic files, go to: http://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10-PCS.html, 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.”

ANSWER KEY (source is the ICD-10-PCS 2014 Device Key):

Appliance, Graft, Implant, or Prosthesis

ICD-10-PCS Device Value

Autograft

Autologous Tissue Substitute

Bone bank bone graft

Nonautologous Tissue Substitute

Bovine pericardial valve

Zooplastic Tissue in Heart and Great Vessels

Brachytherapy seeds

Radioactive Element

Embolization coil(s)

Intraluminal Device

Implanted (venous)(access) port

Vascular Access Device, Reservoir  in Subcutaneous Tissue and Fascia

Peripherally inserted central catheter (PICC)

Infusion Device

PRESTIGE® Cervical Disc

Synthetic Substitute

Tissue bank graft

Nonautologous Tissue Substitute

Total artificial (replacement) heart

Synthetic Substitute

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.