ICD-10-PCS chapters 1 thru 18

When free skin grafts of both epidermal and dermal layers are performed on the skin and breast, they are coded using the qualifier value (character 7) of

3- full thickness.

Putting in autologous or nonautologous bone marrow, pancreatic islet cells, or stem cells is coded to the

Administration section to the root operation of Transfusion.

This term describes a slightly movable joint, such as the connection between the ribs and the sternum.

Amphiarthroses

The body part value (character 4) used to classify the inguinal lymph nodes in the lymphatic and hemic systems is:

C- lymphatic, pelvis.

When a physician severs a nerve root to relieve pain, the root operation coded is:

Division

A physician has performed marsupilization on a cyst in the pharynx. The cyst wall was sutured open. He removed some of the cyst wall during the suturing process. The root operation is:

Excision

Since it is possible to examine the mouth and throat without the use of instruments, a commonly used approach is:

External

Examples of these devices include: a monoplanar device, a uniplane device, limb-lengthening device, and a ring device.

External fixation devices

The physician removed the ocular lens without replacement by an intraocular lens implant. What is the root operation?

Extraction

If a patient has a cataract extraction that does not involve the insertion of an intraocular lens prosthesis, the root operation used is _____, but if the patient has the intraocular lens prosthesis inserted at the same operative episode, then the root operation used is _____.

Extraction, Replacement

Which of the following statements is false regarding ICD-10-PCS?

It is necessary that the physician document the exact terms used in ICD-10-PCS in order for the coder to select a given value.

This approach is defined as "entry by puncture or minor incision of instrumentation through the skin to aid in the performance of the procedure":

Percutaneous endoscopic

This body part, while frequently accessed through the urinary system and the cause of many urinary problems, is not a part of the urinary system in ICD-10-PCS. It is a body part within the male reproductive system.

Prostate

When a physician frees a nerve root from surrounding scar tissue to relieve pain, the root operation coded is:

Release

The physician removed the ocular lens with replacement by an intraocular lens implant. What is the root operation?

Replacement

When resection of the colon is performed to stop postprocedural bleeding, the root operation used is:

Resection

If a patient has a left upper lung lobectomy, the coder will code:

Resection of upper lung lobe, left

When an entire lymph node chain is cut out, the appropriate root operation is _____; but when a lymph node(s) is cut out, the root operation is _____.

Resection, Excision

The AHIMA Practice Brief, Managing an Effective Query Process, identifies ____ reasons why a physician may be queried

Six

_____ nerves send impulses from the brain and spinal cord to skeletal muscle. These nerves are named for the muscles of the body they serve (such as the cervical nerve, ulnar nerve, femoral nerve, or the peroneal nerve).

Somatic

This term describes an immovable joint, such as the sutures between the bones of the head.

Synarthroses

The first character of all ICD-10-PCS codes will begin with:

a letter or a number

This root operation describes procedures performed solely for cosmetic reasons:

alteration

When liposuction is performed for cosmetic purposes, the root operation assigned is:

alteration.

Coders should:

apply accurate, complete, and consistent coding practices for the production of high-quality healthcare data

The _____ nervous system conducts impulses from the brain and spinal cord to smooth muscle tissues, such as the digestive system and the cardiopulmonary system. In ICD-10-PCS, body parts are assigned to the sympathetic divisions of these nerves, based on the body regions of head and neck, thoracic, abdominal, lumbar, and sacral regions.

autonomic

) If a patient has a laparoscopic cholecystectomy converted to an open cholecystectomy, the ICD-10-PCS coding guidelines require that the coder must code:

both percutaneous endoscopic inspection and open resection of the gallbladder

The root operation for a CABG is:

bypass.

When a physician performs a bariatric procedure, whereby he or she creates a bypass between the stomach and the jejunum, commonly referred to as a Roux-en-y, the root operation assigned is:

bypass.

In ICD-10-PCS, all the cranial nerves, 1 through 12, are classified as part of the __________ nervous system.

central

In ICD-10-PCS, cranial nerves are classified as part of the _____ nervous system.

central

There are a few hormone-secreting organs that are considered to be part of the endocrine system, though they are not found in the endocrine system section of ICD-10-PCS. An example is the hypothalamus, which can be found in the:

central nervous system

) If a resection of a joint is performed and then a joint replacement is performed, the coder must:

code only the joint replacement

If multiple tubular body parts are inspected, the coder must:

code the most distal body part inspected

If the physician documents "partial resection of the stomach", the coder should:

code the root operation "Excision"

The root operation _____ specifically involves stopping or attempting to stop _____ bleeding.

control, postprocedural

The patient was treated for a wart on the thumb of his left hand. The physician performed cryotherapy of one wart on the thumb on the left hand. The root operation used to describe this procedure is

destruction.

When a vasectomy is accomplished using electrocautery to sever the vas deferens, the root operation assigned is:

destruction.

A child swallowed a toxic chemical by accident a few months ago. Scar tissue is forming in the esophagus. He has to be taken to his physician to stretch the esophagus and open it up. The root operation is:

dilation.

The root operation for a PTCA is:

dilation.

) Two root operations are similar, in that they both involve cutting or separating a body part only. If the sole objective of the procedure is separating or transecting a body part, the root operation is

division.

If the objective of the procedure is to cut into, transect, or otherwise separate all or a portion of a body part, the root operation is:

division.

Tenotomy is coded to the root operation of:

division.

The placement or insertion of a urinary catheter is coded to the root operation:

drainage

The root operation, _____, is used when lymph node(s) in a chain is (are) cut out without removing the entire lymph node chain.

excision

A patient is seen for elective sterilization and the physician performs a vasectomy by ligating the vas deferens, then excising a portion of the vas deferens. The root operation is

excision.

Sleeve gastrectomy is a procedure performed in bariatric medicine to reduce the size of the stomach by removing the greater curvature of the stomach. The root operation assigned for this procedure is:

excision.

The physician documented that the patient had a "Biopsy of a right breast lesion." The root operation to be coded is

excision.

When a foreign body is removed from a body part, the root operation used is

extirpation.

Since bone marrow is pulled or stripped out during a biopsy, the root operation assigned is:

extraction.

When a patient has a Dilation and Curettage (D & C) procedure performed, the dilation must be performed first to gain access to the endometrium which can then be scraped, either for diagnostic or therapeutic purposes. The root operation for this procedure is:

extraction.

When liposuction is performed for medical reasons (such as obtaining the patient's own fat tissue to use as an autologous tissue substitute), the root operation assigned is:

extraction.

The root operation used to describe an "Extracorporeal Shock Wave Lithotripsy" procedure is

fragmentation.

When a urinary calculus is broken up, such as with extracorporeal shockwave lithotripsy, the root operation assigned is:

fragmentation.

Excisional debridement that includes skin and subcutaneous tissue and muscle is coded to the _____body part.

muscle

This approach is not available as an option in the muscular system:

natural orifice

When coding coronary bypass operations, the fourth character identifies the _____ and the seventh character qualifier specifies the _____.

number of distinct coronary artery sites treated or bypassed to; origin of the bypass or the vessel bypassed from

In ICD-10-PCS, the coding of coronary bypass procedures is different from the coding of non-coronary bypass procedures. When coding a coronary bypass, the "body part" (character 4) is the:

number of distinct sites treated

The fifth character of the ICD-10-PCS code is for the approach which identifies the method used to reach the operative site. This approach involves a puncture or minor incision through the skin or mucous membrane and any other body layers necessary using instrumentation to reach the site of the procedure:

percutaneous approach

The stomach is divided into areas called the cardia, fundus, body, antrum, and pylorus. The only division of the stomach that is identified by an individual body part value in ICD-10-PCS is the:

pylorus

There are many eponyms used when coding procedures from the "Ear, Nose, and Sinus" body system. When it is unclear what the objective of the procedure is and the coder is unsure of what root operation to use, the coder should:

query the physician

Tenolysis is coded to the root operation of:

release.

This root operation is considered to be one of last resort and should only be used if none of the other root operations do not apply:

repair

If the physician documents that the patient had a cornea transplant from a cadaver donor, the root operation is:

replacement.

The root operation used for a reduction of a displaced fracture is _____.

reposition

The root operation used to code an orchiopexy is:

reposition.

If a renal transplant is rejected, the later removal of the transplanted kidney is coded to the root operation:

resection.

ICD-10-PCS defines "skin" as including:

the epidermis and dermis.

The thymus gland is located in the

thoracic cavity

In ICD-10-PCS, the coding of coronary bypass procedures is different from the coding of non-coronary bypass procedures. When coding a coronary bypass, the "qualifier" (character 7) is the:

vessel (body part) bypassed from.

When a physician performs a cystoscopy, the approach for this procedure is:

via natural or artificial opening, endoscopic

The trapezium, trapezoid, and scaphoid bone are bones of the

wrist

The second character value for the male reproductive body system is

"V"

A healthcare provider should be queried when documentation is:

Conflicting, Incomplete, or Ambiguous

When cautery is used to control postoperative hemorrhage, the root operation used is:

Control

If the patient has an amputation of a supernumerary digit and it contains only soft tissue and no bone, the root operation of __________________is selected.

Destruction

If the patient has an amputation of a supernumerary digit and it contains bone and soft tissue, the root operation ___________________is selected.

Detachment

This term describes a freely movable joint, such as shoulders, knees, and elbows.

Diarthroses

The fourth character in ICD-10-PCS depicts the body part. Some body parts are further subdivided into more detailed parts. The lung is divided into nine unique body parts; therefore, if one of these unique body parts (such as: right upper lobe of the lung, right middle lobe of the lung, right lower lobe of the lung) is removed, the appropriate root operation would be

resection.

The root operation assigned for a patient that has a circumcision is:

resection.

When an entire lymph node chain is cut out, the appropriate root operation is:

resection.

When a physician performs a bariatric procedure, whereby he or she applies adjustable gastric bands to reduce the size of the stomach, the root operation assigned is:

restriction.

In the Medical and Surgical section, the third character of the ICD-CM-PCS code always represents the:

root operation

The total number of characters in an ICD-10-PCS code is:

seven

Devices are depicted by character:

six

Bone marrow is the spongy tissue inside some of the large bones. It contains immature cells, called _____. These can develop into the red blood cells that carry oxygen through the body, the white blood cells that fight infections, and the platelets that help with blood clotting.

stem cells

When coding transplant procedures, this term is used to identify the seventh character (Qualifier) and it means "having to do with individuals or tissues that have identical genes, such as identical twins:"

syngeneic.

When a specific branch of a body part does not have its own body part value in ICD-10-PCS, the body part is coded to:

the closest proximal branch that has a specific body part value

In Transfer procedures that involve more than one layer (such as the subcutaneous tissue, fascia, and muscle body parts), the body part value represents:

the deepest tissue layer in the flap.

The term hindquarter includes:

the entire lower limb, the pelvic girdle, and the buttock

Bone marrow transplantation is coded using the root operation:

transfusion (located in the Administration section).

At the proximal end, the femur has a head, neck, and _____.

trochanter