We have primarily focused on inpatient procedures in the Coding Tidbits. However, most hospitals require dual coding for outpatient procedures, both ICD and CPT. The Placement section includes several types of outpatient procedures, procedures which we will discuss this week.
- Placement procedures involve services performed without making any incision or puncture.
- The 7 characters that make up a PCS code in this section are almost the same as those in the Med/Surg section.
- Character 1: Always Placement
- Character 2, Body System: There are only 2 character values for the 2nd character:
- Anatomical Regions such as head, right inguinal region, abdominal wall, etc.
- Anatomical Orifices such as mouth, pharynx, ear, urethra, etc.
- Character 3, Root Operation: Compression, Dressing, Immobilization, Packing and Traction.
- Character 4, Body Region: There are 2 general types of Body Regions in the Placement section which correspond to the 2nd character Body System values: W for Anatomical Regions or Y for Anatomical Orifices.
- Character 5, Approach: There is only one valid 5th character for Approach in the Placement section – X for External. No incision or puncture is made and the procedures are either performed on the skin or mucous membranes or by the use of force or external pressure.
- Character 6, Device: The Device character typically designates the material used in a placement procedure such as splint, cast, brace, etc.
- Please note that at this time there are no valid characters for the 7th character filed for Placement procedures. Therefore, assign Z, No Qualifier, for all procedures.
Coding problems for this week:
- Insertion of nasal packing.
- Placement of pressure dressing on abdominal wall wound.
- Splint placement, right lower leg.
Problem #1, Insertion of nasal packing.
To Locate: PCS Index > Packing > Nasal > 2Y41X5Z > Locate table 2Y4 to verify that the code given in the Index is correct:
Packing of nasal region using packing material
Problem #2, Placement of pressure dressing on abdominal wall wound.
To Locate: PCS Index > Abdominal Wall > 2W13X > locate table 2W1 and go across the row to complete the code:
Compression of abdominal wall using pressure dressing
Problem #3, Splint placement, right lower leg.
To Locate: PCS Index > Immobilization > Leg > Lower > Right > 2W3QX > Locate table 2W3 to complete the code:
Immobilization of right lower extremity using splint