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The multiple procedure guidelines in ICD-10-PCS present possibilities for coder confusion. Several guidelines relate to the coding of multiple procedures, some under the heading of multiple procedures and others dispersed throughout the various root operation guidelines.

One ICD-10-PCS multiple procedure guideline states coders can report multiple procedures when the same root operation is performed on different body parts as defined by distinct values of the body part character.

Coders build an ICD-10-PCS code by using a ‘table’ format that will allow them to construct multiple codes from a single table. In some cases, coders can construct more than 200 possible codes from a single table.

Within the various sections of ICD-10-PCS, each character of the seven-character alphanumeric code identifies ‘specific’ or ‘general’ values.

In the Medical &Surgical section, if separate body part (character 4) values exist, then coders must report multiple codes.

For example, if a physician performed an open total abdominal hysterectomy (removing both the uterus and the cervix), we would look at root operation Resection (cutting out or off, without replacement, all of a body part) in the alphabetic index. This leads us to table 0UT-.

Character 4 contains ‘separate’ character values for the uterus (9) and the cervix (C). Therefore, in order to report the procedure we would need to report two codes:

    0UT90ZZ
    0UTC0ZZ


Also, if the physician removed tubes and ovaries, we would report additional codes for this procedure.
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