Coding Notes
Root Operations of the Central and Peripheral Nervous System
THERE ARE 20 root operations relevant to the central and peripheral nervous system. Coders should begin familiarizing themselves with the root operations and their definitions to prepare for coding in ICD-10-PCS.
ROOT OPERATION
Bypass ( 1)
Change ( 2)
Destruction ( 5)
Division ( 8)
Drainage ( 9)
Excision (B)
Extirpation (C)
Extraction (D)
Fragmentation (F)
Insertion (H)
Inspection (J)
Map (K)
Release (N)
Removal (P)
Repair (Q)
Reposition (S)
Resection (T)
Supplement (U)
Revision (W)
Transfer (X)
DEFINITION
Altering the route of passage of the contents of a tubular body part
Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part
without cutting or puncturing the skin or a mucous membrane
Physical eradication of all or a portion of a body part by the direct use of energy, force, or a destructive agent
Cutting into a body part, without draining fluids and/or gases from the body part, in order to separate or transect a body
part
Taking or letting out fluids and/or gases from a body part
Cutting out or off, without replacement, a portion of a body part
Taking or cutting out solid matter from a body part
Pulling or stripping out or off all or a portion of a body part by the use of force
Breaking solid matter in a body part into pieces
Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not
physically take the place of a body part
Visually and/or manually exploring a body part
Locating the route of passage of electrical impulses and/or locating functional areas in a body part
Freeing a body part from an abnormal physical constraint
Taking out or off a device from a body part
Restoring, to the extent possible, a body part to its normal anatomic structure and function
Moving to its normal location, or other suitable location, all or a portion of a body part
Cutting out or off, without replacement, all of a body part
Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a
body part
Correcting, to the extent possible, a portion of a malfunctioning device or the position of a displaced device
Moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion
of a body part
Codes from category G81, Hemiplegia and hemiparesis, and
subcategories, G83.1, Monoplegia of lower limb, G83.2, Mono-
plegia of upper limb, and G83.3, Monoplegia, unspecified,
identify whether the dominant or nondominant side is affected.
Should the affected side be documented but not specified as
dominant or nondominant and the classification system does
not indicate a default, code selection is as follows:
The terminology for epilepsy has been updated, with terms
to classify the disorder such as localization-related idiopathic
epilepsy, generalized idiopathic epilepsy, and special epileptic
syndromes. Within those various categories, more specificity is
possible, such as identifying seizures of localized onset, com-
plex partial seizures, and intractable and status epilepticus.
Nervous System Procedure Coding in ICD-10-PCS
The central and peripheral nervous system are found in the
medical and surgical section of ICD-10-PCS. All ICD-10-PCS
codes are seven characters long with each of the seven characters representing an aspect of the procedure. The diagram at left
