Revisiting a Not-So-Hidden Gem in ICD-10-PCS

There is a certain not-so-hidden gem ICD-10-PCS: the body-part key. PCS coding can be challenging, so it is vital to take advantage of all the assistance we are given from the classification itself. You might be surprised to know how many coders forget about this tool, and how many newer coders may not be aware it exists. 

The body-part key in PCS provides a mapping or translation from a list of anatomical sites to the appropriate body-part value in a PCS code. Remember, in the seven-character PCS code, the body-part value is represented in the fourth character place. Not every anatomical site is represented in the list, but coders will find it particularly helpful with arteries, veins, nerves, and muscles. Some of the mappings are obvious; for example when the term “abdominal cavity” is used, the appropriate body part is the peritoneal cavity. Others may not be as obvious; as an example, when the term “cardia” is used, the appropriate body part is the esophagogastric junction. This one is a commonly occurring error. 

This tool takes the guesswork out of many, not all, of those confusing anatomical coding issues we all encounter. As part of your coding practice, when building a PCS code, you may encounter body-part options that don’t seem to correspond to the documentation you are reviewing. Remember, providers do not need to document in PCS terminology. Generally, we think about this in terms of our root operation definitions, but this is the case anatomically as well. It is the coder’s responsibility to know anatomy and physiology, so again, the body-part key is a great tool. 

So, if the body-part key is such a great help, and I think it is, why aren’t coders using it? Or why don’t they know it exists? Hopefully we old-timers who learned coding using the book (and some of whom still like to use the book) know where to find the body-part key, and remember to use it when some clarification is needed. Many of us, however, now do the bulk of our work in encoders or computer-assisted coding (CAC) systems, and unless we have a current book for reference, the body-part key is often difficult to find. I challenge you this week to look at the system you use and find the body-part key. It may be found in an online appendix, in a tools, help, or reference tab, or maybe even located in a table or index. For those newer coders who didn’t learn using the book, as noted, they may not know the body-part key exists. They may have learned coding using an encoder. In some cases, the PCS code tables themselves can cause some confusion, depending on the system they were using. If they learned using a question/answer format encoder, the thought of building a PCS code (or even the values of the code characters themselves) may not be familiar. 

Make sure your coding team is aware of this tool and where to find it. For an educational opportunity, create a short quiz using the body-part key. It could consist of questions regarding matching the site to the value, multiple-choice, or fill-in-the-value for particular sites. It will not only ensure they find and reference the body-part key, but may also expose some education gaps where additional training would be valuable. 

Help your team find this not-so=hidden gem in PCS, and watch their coding shine.