icd-10 procedure coding system icd-10 procedure coding system the icd-10 procedure coding system (icd-10-pcs) is an international system of medical classification used for procedural coding. the centers for medicare and medicaid services, the agency responsible for maintaining the inpatient procedure code set in the u.s., contracted with 3m health information systems in 1995 to design and then develop a procedure classification system to replace volume 3 of icd-9-cm. icd-9-cm contains a procedure classification; icd-10-cm does not. icd-10-pcs is the result. icd-10-pcs was initially released in 1998. it has been updated annually since that time. section structure each code consists of seven alphanumeric characters. the first character is the 'section'. the second through seventh characters mean different things in each section. each character can be any of 34 possible values the ten digits 0-9 and the 24 letters a-h, j-n and p-z may be used in each character. the letters o and i are excluded to avoid confusion with the numbers 0 and 1. there are no decimals in icd-10-pcs of the 72,081 codes in icd-10-pcs, 62,022 are in the first section, "medical and surgical". character 1 character 2 character 3 character 4 character 5 character 6 character 7 0 medical and surgical body system0 central nervous system; 1 peripheral nervous system; 2 heart and great vessels; 3 upper arteries; 4 lower arteries; 5 upper veins; 6 lower veins; 7 lymphatic and hemic system; 8 eye; 9 ear, nose, sinus; b respiratory system; c mouth and throat; d gastrointestinal system; f hepatobiliary system and pancreas; g endocrine system; h skin and breast; j subcutaneous tissue; k muscles; l tendons; m bursae and ligaments; n head and facial bones; p upper bones; q lower bones; r upper joints; s lower joints; t urinary system; u female reproductive system; v male reproductive system; w anatomical regions, general; x anatomical regions, upper extremities; y anatomical regions, lower extremities root operationsee below body part approach0 open; 3 percutaneous; 4 percutaneous endoscopic; 7 via natural or artificial opening; 8 via natural or artificial opening endoscopic; f via natural or artificial opening endoscopic with percutaneous endoscopic assistance; x external device qualifier 1 obstetrics 10 pregnancy 102 change; 109 drainage; 10a abortion; 10d extraction; 10e delivery; 10h insertion; 10j inspection; 10p removal; 10q repair; 10s reposition; 10t resection; 10y transplantation body part approach device qualifier 2 placement 2w anatomical regions; 2y anatomical orifices root operation2?0 change; 2?1 compression; 2?2 dressing; 2?3 immobilization; 2?4 packing; 2?5 removal; 2?6 traction body region/orifice approach device qualifier 3 administration 30 circulatory; 3cindwelling device; 3e physiological systems and anatomical regions root operation body system/region approach substance qualifier 4 measurement and monitoring 4a physiological systems; 4b physiological devices root operation body system approach function qualifier 5 extracorporeal assistance and performance 5a physiological systems root operation body system duration function qualifier 6 extracorporeal therapies 6a physiological systems root operation6a0 atmospheric control; 6a1 decompression; 6a2 electromagnetic therapy; 6a3 hyperthermia; 6a4 hypothermia; 6a5 pheresis; 6a6 phototherapy; 6a7 ultrasound therapy; 6a8 ultraviolet light therapy; 6a9 shock wave therapy body system duration qualifier qualifier 7 osteopathic 7w 7w0 body region approach method qualifier 8 other procedures 8c indwelling device; 8e physiological systems and anatomical regions root operation body region approach method qualifier 9 chiropractic 9w 9wb body region approach method qualifier b imaging body system0 central nervous system; 2 heart; 3 upper arteries; 4 lower arteries; 5 veins; 7 lymphatic system; 8 eye; 9 ear, nose, mouth and throat; b respiratory system; d gastrointestinal system; f hepatobiliary system and pancreas; g endocrine system; h skin, subcutaneous tissue and breast; l connective tissue; n skull and facial bones; p non-axial upper bones; q non-axial lower bones; r axial skeleton, except skull and facial bones; t urinary system; u female reproductive system; v male reproductive system; w anatomical regions; y fetus and obstetrical root type body part contrast0=high osmolar contrast; 1=low osmolar contrast; z=other contrast qualifier qualifier c nuclear medicine body system0 central nervous system; 2 heart; 5 veins; 7 lymphatic and hematologic system; 8 eye; 9 ear, nose, mouth and throat; b respiratory system; d gastrointestinal system; f hepatobiliary system and pancreas; g endocrine system; h skin, subcutaneous tissue and breast; p musculoskeletal system; t urinary system; v male reproductive system; w anatomical regions root type body part radionuclide qualifier qualifier d radiation oncology body system0 central and peripheral nervous system; 7 lymphatic and hematologic system; 8 eye; 9 ear, nose, mouth and throat; b respiratory system; d gastrointestinal system; f hepatobiliary system and pancreas; g endocrine system; h skin; m breast; p musculoskeletal system; t urinary system; u female reproductive system; v male reproductive system; w anatomical regions root type body part modality qualifier isotope qualifier f physical rehabilitation and diagnostic audiology f/0 rehabilitation; f/1 diagnostic audiology root type body system & region type qualifier equipment qualifier g mental health gz none root typegz1 psychological tests; gz2 crisis intervention; gz3 medication management; gz5 individual psychotherapy; gz6 counseling; gz7 family psychotherapy; gzb electroconvulsive therapy; gzc biofeedback; gzf hypnosis; gzg narcosynthesis; gzh group psychotherapy; gzj light therapy type qualifier qualifier qualifier qualifier h substance abuse treatment hz none root type type qualifier qualifier qualifier qualifier x new technology root operations for medical/surgical, these are the root operation codes: 00 alteration; 01 bypass; 02 change; 03 control; 04 creation; 05 destruction; 06 detachment; 07 dilation; 08 division; 09 drainage; 0b excision; 0c extirpation; 0d extraction; 0f fragmentation; 0g fusion; 0h insertion; 0j inspection; 0k map; 0l occlusion; 0m reattachment; 0n release; 0p removal; 0q repair; 0r replacement; 0s reposition; 0t resection; 0u supplement ; 0v restriction; 0w revision; 0x transfer; 0y transplantation they can be grouped into several categories: take out or eliminate all or a portion of a body part: excision (sigmoid polypectomy), resection (total nephrectomy), extraction (toenail extraction), destruction (rectal polyp fulguration), detachment (below knee amputation). for biopsies, "extraction" is used when force is required (as with endometrial biopsy), and "excision" is used when minimal force is involved (as with liver biopsy).