ICD 10 Coding Alert

Question: I've read articles or heard instructors who use "x" as a way to show that codes need an additional digit. A co-worker says the "x" will have a different meaning in ICD-10-PCS. Can you explain?

Georgia Subscriber

Answer: Your co-worker is right: "x" can be a placeholder under ICD-10 but won't have that role under ICD-10-PCS. The ICD-10-PCS codes are so detailed that the concept of placeholders doesn't exist. Because of that, an "X" in an ICD-10-PCS code carries particular meaning instead of simply filling a spot.

Explanation: Each ICD-10-PCS code is a seven-digit combination of letters and numbers, with each digit (or character) telling you something about the procedure (body system, root operation, body part, surgical approach, etc.).

You'll use categories and cross-reference charts to determine the appropriate letter or number for each digit in the code. An "X" can be one of those characters, and its meaning will depend on its position in the code and section involved.

For example, "X" can represent anatomical regions/upper extremities when placed as the second character in the code. But "X" can also represent an external approach when listed as the code's fifth character, or a diagnostic test when listed as the seventh character. It all depends on knowing what each character in the code signifies.

For example, look at 0G9G4ZX. The "X" in this case shows that the fine-needle aspiration biopsy of the left lobe of the thyroid was done for diagnostic purposes.