In ICD-10-PCS coding, the root operation describes the intent or the objective of the procedure and is expressed by the value of the third character in a code. Because identification of the root operation plays a significant role in selection of the appropriate ICD-10-PCS code table, the root operation must be determined before assigning a specific code for a procedure can begin. In order to determine the appropriate root operation, the full definition of the root operation as contained in the ICD-10-PCS Tables must be applied.
The majority of ICD-10-PCS code tables are found in the Medical and Surgical section. There are 31 root operations available in this section. A list of root operations, along with their definitions, explanation and examples can be found in the References section of the ICD-10-PCS classification.
Root operations in the Medical and Surgical section can be arranged into 9 groups based on shared attributes that describe the intent/objective of the procedure. Each group lists the root operations included in that group and describes the common attribute they share as seen below.
| Group Description | Root Operations |
| Root operations that take out some or all of a body part | Excision, Resection, Detachment, Destruction, and Extraction |
| Root operations that take out solids/fluids/gases from a body part | Drainage, Extirpation, and Fragmentation |
| Root operations involving cutting or separation only | Division and Release |
| Root operations that put in/put back or move some/all of a body part | Transplantation, Reattachment, Transfer, and Reposition |
| Root operations that alter the diameter/route of a tubular body part | Restriction, Occlusion, Dilation, and Bypass |
| Root operations that always involve a device | Insertion, Replacement, Supplement, Change, Removal, and Revision |
| Root operations involving examination only | Inspection and Map |
| Root operations that define other repairs | Control and Repair |
| Root operations that define other objects | Fusion, Alteration, and Creation |
In this course, participants will delve into the intricacies of ICD-10-PCS coding, focusing primarily on the Medical and Surgical Section. Through comprehensive readings from the ICD-10-PCS Reference Manual and Official Coding Guidelines, learners will gain a thorough understanding of root operations and their definitions, with a special emphasis on distinguishing between Control and more specific root operations. This course equips coders with the knowledge to make accurate code assignments when dealing with postprocedural or other acute bleeding scenarios. Practical examples and real-world cases, such as the management of bleeding duodenal ulcers and intraoperative hemorrhages, will be explored to reinforce these concepts.
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The information contained in this blog post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.