My experience at an AHIMA trainer session Part 2
In a recent post, I talked about my experience attending an American Health Information Management Association (AHIMA) Academy for ICD-10 trainer session. While I am excited about certain aspects of ICD-10-CM, I’m not as quick to warm up to ICD-10-PCS, which is very different from what we currently use in ICD-9-CM Volume 3.
The use of the many tables and definitions of certain procedures make this system much more applicable in a clinical sense. However, I did find myself having to continually reference definitions of the various root operations in the front of the PCS manual.
I would read a question and have to really think about whether the question was about a “change,” “replacement,” “extraction,” “extirpation,” etc.
Extirpation was my word of the day. I looked this word up in the Merriam-Webster Dictionary only to find the definition includes the following:
- To pull up by the roots
- To destroy completely
- To remove by surgery
Well, that didn’t help me much considering some of my choices for root operations include destruction, resection, transplantation, and excision, which all seem similar, don’t they?
Luckily, the introduction to the ICD-10-PCS manual provides a specific definition for extirpation, which is “taking or cutting out solid matter from a body part” (e.g., removal of a calculus). I’m glad this definition was in the manual otherwise I would have had a hard time using the official definition.
One of the comments people made at the AHIMA session was, “Will all my physicians have to document ‘extirpation’?” Rest assured, physicians do not need to use this exact verbiage for coders to assign the appropriate ICD-10-PCS codes.
However, because of the way the ICD-10-PCS system is set up, you do need to understand what the root operations are so you can reference the correct part of the procedure tables, identify the procedures the physicians document, and assign the correct codes.
About the Author: Shannon McCall, RHIA, CCS, CCS-P, CPC-I, is director of coding and HIM at HCPro, Inc. where she manages the instructors of the Certified Coder Boot Camps® which cover physician and outpatient hospital coding and inpatient hospital facility coding. As a lead consultant for HCPro’s Revenue Cycle Institute, she works with hospitals, medical practices, and other healthcare providers on a wide range of coding-related issues with a particular focus on coding reviews and audits. McCall has extensive experience with coding for both physician and hospital services. Prior to joining HCPro, Inc., she worked for Per-Se Technologies, a national medical practice management company, where her duties included serving as instructor for Per-Se’s in-house coding training and certification program.
