Devices and Qualifiers in ICD-10-PCS

Device

The sixth character of the Medical and Surgical Section is for the device. This is not true of all sections (for example, in the Radiation Oncology section the sixth character is for the use of isotopes). We are going to focus on the Medical and Surgical section (0) as that is what you will most commonly come across.

The devices in this section are meant to represent things that remain after the procedure are completed. If the device is removed prior to the completion of the procedure then we do not assign a device character (in this instance we would use character Z for no device)

Basically, you will come across four types of devices:

  1. Biological or synthetic material that takes the place of all or a portion of a body part - like a skin graft or joint prosthesis
  2. Therapeutic material that is not absorbed by, eliminated by, or incorporated into a body part - such as a radioactive implant, or orthopedic pins.
  3. Biological or synthetic material that assists or prevents a physiologic function - such as a urinary catheter or IUD
  4. Mechanical or electronic appliances used to assist, monitor, take the place of, or prevent a physiological function - such as a pacemaker or hearing aid.

 

Device characters within the Medical Surgical Section

Character

Device

0

Drainage Device

1

Radioactive element

2

Monitoring device

3

Infusion device

7

Autologous tissue substitute

C

Extraluminal device

D

Intraluminal device

J

Synthetic substitute

K

Nonautologous tissue substitute

L

Artificial sphincter

M

Electrode

Y

Other device

Z

No device

Some key terms to know:

 

*Spoiler alert - the most commonly used device will be character Z - no device.

 

Things like clips, ligatures, or sutures are NOT considered devices in this section.

 

Coding Guidelines for Device

B6. Device

General guidelines

B6.1a

A device is coded only if a device remains after the procedure is completed. If no device remains, the device value No Device is coded.

B6.1b

Materials such as sutures, ligatures, radiological markers and temporary post-operative wound drains are considered integral to the performance of a procedure and are not coded as devices.

B6.1c

Procedures performed on a device only and not on a body part are specified in the root operations Change, Irrigation, Removal and Revision, and are coded to the procedure performed.

Example: Irrigation of percutaneous nephrostomy tube is coded to the root operation Irrigation of indwelling device in the Administration section.

Drainage device

B6.2

A separate procedure to put in a drainage device is coded to the root operation Drainage with the device value Drainage Device.

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Device Key

There are man many different types of devices. Here is a device key to help you out (it is quite long and you may want to just bookmark it instead of printing it). You can also find it at the end of your Index and Tables for the pdf version of the PCS book.

Device Key for all sections found at http://www.tacomacc.edu/UserFiles/Servers/Server_6/File/him//him240/pcs/devicekey.pdf

Device key for just the Medical Surgical Section: http://www.tacomacc.edu/UserFiles/Servers/Server_6/File/him//him240/pcs/devicemedsurg.pdf

 

Qualifier

The seventh character for all sections refers to a "qualifier". Each section has its own unique meaning as to the qualifiers in the particular section.

Here is a listing of qualifiers for the Medical and Surgical Section (0)

0

Allogeneic

1

Syngeneic

2

Zooplastic

3

Kidney Pelvis, Right

4

Kidney Pelvis, Left

6

Ureter, Right

7

Ureter, Left

8

Colon

9

Colocutaneous

A

Ileum

B

Bladder

C

Ileocutaneous

D

Cutaneous

X

Diagnostic

Z

No Qualifier

You can see from the listing above that there are still many numbers and letters that have not been used. This character has the ability to expand greatly if needed.

*Spoiler alert - the most commonly used Qualifier will be Z.

Again - there are some terms you may be unfamiliar with

 

There are no specific coding guidelines that reference Qualifiers.