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6) CPT 4 and ICD-10-PCS
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Terms in this set (26)
What are the 2 sets of codes used to bill inpt procedural services?
CPT-4 and ICD-10-PCS
What does does ICD-10-PCS stand for?
International Classification of Diseases - 10th Revision - Procedure Coding System
What are CPT-4's used for?
reimbersement for outpt procedures and physician encounters
What is ICD-10-PCS used for?
hospital's inpt billing
Does CPT4 or ICD-10 PCS have more detail in particular procedures?
CPT-4
Does CPT4 or ICD-10 PCS have greater specificity that includes approaches, devices, and qualifiers
ICD-10-PCS
Does CPT-4 or ICD-10 PCS use eponyms?
CPT-4
Does CPT-4 or ICD-10 PCS use only medical terminology largely derived from word parts?
ICD-10-PCS
When is CPT 4 updated?
Annually on Jan 1
When is ICD-10-PCS updated?
Annually on Oct 1
Where can you find changes and additions to both CPT 4 and ICD-10-PCS
AMA & CDC websites
What is a CPT 4
a 5 digit, multi-axial nomenclature
What do the axes of CPT 4 describe?
TBBS
type of service, body system, body part, and specific procedure
What are the axes or types of services CPT 4 describes
MR.PLEAS
medicine
radiology
pathology
labratory
e/m
anesthesia
surgery
What do 2 digit modifiers appended to the CPT code do?
further define the service provided
(eg. bilateral procedures, repeat clin lab tests, prev serv, etc)
What is the PCS volume of the ICD-10?
a multi-axial, 7 character classification system that replaces ICD-9-PCS/Vol 3
What does the overall structure of the PCS volume of the ICD-10 begin with?
Sections - broad categories that divide all the procedures into 16 different types
What are the 16 sections of the PCS volume of the ICD-10?
My Old Paw Always Milks Emmy and Elly Over Other Cows Inthebarn Never Really Proffering Much Since Nelly
0) Medical & Surgical
1) Obstetrics
2) Placement
3) Administration
4) Measurement & Monitoring
5) Extracorporeal or System Assistance and Performance
6) Extracorporeal or Systemic Therapies
7) Osteopathic
8) Other Procedures
9) Chiropractic
B) Imaging
C) Nuclear Medicine
D) Radiation Therapy
F) Physical Rehabilitation & Diagnostic Audiology
G) Mental Health
H) Substance Abuse & Treatment
X) New Technology
What is the largest section of the PCS volume of the ICD-10?
Medical & Surgical
What is the Medical & Surgical Section of the PCS volume of the ICD-10 divided into?
Body Systems (body system values) - a grouping of body parts or body systems
eg: endocrine system, respiratory system
What are the Body Systems of the Medical & Surgical section of the ICD-10-PCS subdivided into?
Root Operations (operation values) - the goal of the procedure
eg: resection (cutting out or off, without replacement, all of a body part
eg: inspection (visually and/or manually exploring a body part"
What are root operations further coded for?
approach, device, and qualifier
What is "approach" in an ICD-10-PCS code
the method of access to the procedure site
What is "device" in an ICD-10-PCS code
the instrument used but is only specified when it remains after the procedure is completed
What is "qualifier" in an ICD-10-PCS code
any additional information particular to that procedure; it is a specified final characteror the PCS
What is the end goal of using PCS?
to uniquely identify every procedure with one specific and exclusive code.
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