Inpatient Facility Coding & Compliance Alert

Question: I know that the diagnosis codes under ICD-10-PCS will have seven characters and that each character will represent something specific. I’ve been focusing on learning the basic character meanings, but now I’ve heard that the characters will be different for some specialties, like rehab. What’s the difference?

Arkansas Subscriber

Answer:  ICD-10-PCS will bring a new way of looking at diagnosis codes when it’s implemented in October. Much of the information you’ve seen probably focuses on what each character will represent when you code for medical or surgical cases (section, body system, root operation, body part, approach, device, and qualifier). As you mention, however, those same seven character definitions won’t apply to every specialty or service.

Example: You mentioned rehab services, so let’s look at that area. You’ll still have seven characters making up each diagnosis code, but here’s what they’ll represent:

• Character 1 – Section (which for physical rehabilitation and diagnostic audiology will always be F)
• Character 2 – Section qualifier (either “rehabilitation” or “diagnostic audiology”)
• Character 3 – Root type (a group of 14 values classified into four basic types of physical rehab or diagnostic audiology procedures: assessment, caregiver training, fitting, or treatment)
• Character 4 – Body system and region on which the service is performed
• Character 5 – Type qualifier (further specifies the procedure, such as PT to improve range or motion)
• Character 6 – Equipment (broad categories of equipment used, such as assistive/adaptive/supportive)
• Character 7 – Qualifier (which will always be ‘none’ because the Physical Rehab and Diagnostic Audiology section doesn’t specify particular qualifiers).

Radiation oncology, mental health, nuclear medicine, and several other areas of care also have their own sets of character definitions under ICD-10-PCS. If you code for any services outside of general medicine/surgery, be sure to check training resources to learn how your reporting will differ.