Wiki ICD-10-PCS questions

[Samantha.Prince]

Hi All -

I'm currently a COC and a CPC with an inpatient coding question regarding reimbursement. It's outside of my current scope so I'm asking here.

1) Do ALL inpatient claim require at lease one ICD-10-PCS code? My thought process was yes because the book states ICD-10-PCS codes are used for ancillary services: Imaging, Nuclear Medicine, Radiation Therapy, Physical Rehabilitation and Diagnostic Audiology, Mental Health, and substance abuse. (page 20 Optum edition)

2) If yes, what kind of PCS code would be used for a newborn baby girl?

3) Clarification.... inpatient claims without a PCS get grouped by only the Dx?

Thank you!

 

[lpoe]

My only answer for you is #2. It would depend on how the child was born; C-section or Vaginally. Root operation is either 10D for C-section and 10E for vaginal birth.

 

[mitchellde]

Inpatient claims are always classified by the diagnosis into the DRG. Sometimes certain procedures will modify the DRG. So there are times when there are only dx codes on an inpatient claim.