Ophthalmology and Optometry Coding Alert

Reader Question:

When Does ICD-10 PCS Apply?

Question: Should we be capturing ICD-10-PCS codes in our eye care practice? We currently use ICD-10-CM but we have never used ICD-10-PCS codes.

Codify Subscriber

Answer: The codes you're referring to are special ICD-10 procedure codes, not diagnosis codes. They are different than the more common and ICD-10-CM diagnosis and CPT® codes. ICD-10 procedure codes are typically only applicable when the patient is assigned to inpatient status. Most hospitals don't assign ICD-10-PCS codes to any procedure performed for a patient who is in an outpatient status since the code set isn't applicable in that setting of care, nor will you use these codes in an outpatient practice.  


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