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ICD-10-PCS
Physical Rehabilitation
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The ICD-10-PCS Official Guidelines for Coding and Reporting 2016 do not provide us with any specific direction when coding
physical rehabilitation cases. Knowing this, we then must use the information found in the introduction to the Guidelines
which states, “The instructions and conventions of the classification take precedence over guidelines.”
When looking up the term “Rehabilitation” in the index of ICD-10-PCS we find the following:
Rehabilitation
see Speech Assessment, Rehabilitation F00
see Motor Function Assessment, Rehabilitation F01
see Activities of Daily Living Assessment, Rehabilitation F02
see Speech Treatment, Rehabilitation F06
see Motor Treatment, Rehabilitation F07
see Activities of Daily Living Treatment, Rehabilitation F08
see Hearing Treatment, Rehabilitation F09
see Cochlear Implant Treatment, Rehabilitation F0B
see Vestibular Treatment, Rehabilitation F0C
see Device Fitting, Rehabilitation F0D
see Caregiver Training, Rehabilitation F0F
All the codes are in Section F, Physical Rehabilitation and Diagnostic Audiology, so let’s take a look at the characters.
Character 1, Section: F is the value that represents Physical Rehabilitation and Diagnostic Audiology as the first character.
Physical Rehabilitation and Diagnostic Audiology contains character definitions for characters 2-6 which are unlike the other
sections in ICD-10-PCS.
Character 2, Section Qualifier: Specifies whether the procedure is a rehabilitation or diagnostic audiology procedure.
Character 3, Root Type: Defines the general procedure root type. There are currently fourteen (14) root types in the
Physical Rehabilitation and Diagnostic Audiology Section. The Root Types will fit into one of four broad categories:
1.
2.
3.
4.
Treatment: Use of specific activities or methods to develop, improve and/or restore the performance of necessary
functions, compensate for dysfunction and/or minimize debilitation
Assessment: Includes a determination of the patient’s diagnosis when appropriate, need for treatment, planning
for treatment, periodic assessment and documentation related to these activities
Fitting(s): Design, fabrication, modification, selection and/or application of splint, orthosis, prosthesis, hearing
aids and/or rehabilitation device
Caregiver Training: Educating caregiver with the skills and knowledge used to interact with and assist the patient
Character 4, Body System and Region: Defines the body system or body region studied, which may be combined, where
applicable.
Character 5, Type Qualifier: This character further specifies the procedure type.
Character 6, Equipment: This character specifies the equipment used, if any. This is an exception to the rule that in
ICD-10-PCS, equipment used to assist in the performance of the procedure is not coded.
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Character 7, No Qualifier: This character is a qualifier, and is not specified in the Physical Rehabilitation and Diagnostic
Audiology Section. Currently the only value choice available for this character is: Z – None.
Let’s work with a scenario that would fall under category Treatment.
Scenario: Inpatient rehabilitation, patient receiving wound care treatment of left calf ulcer, down to the muscle, using
pulsatile lavage. F08L5BZ
ICD-10-PCS Index
Activities of Daily Living Treatment, Rehabilitation F08
ICD-10-PCS Table
Section
F
Section Qualifier 0
8
Type
Physical Rehabilitation and Diagnostic Audiology
Rehabilitation
Activities of Daily Living Treatment: Exercise or activities to facilitate functional competence for activities of
daily living
Body System / Region
D Integumentary System –
Type Qualifier
5 Wound Management
Head and Neck
F Integumentary System –
Upper Back / Upper Extremity
G Integumentary System –
Lower Back / Lower Extremit y
H Integumentary System –
Whole Body
J Musculoskeletal System –
Equipment
B Physical Agents
Qualifier
Z None
C Mechanical
D Electrotherapeutic
E Orthosis
F Assistive, Adaptive
Supportive or Protective
U Prosthesis
Y Other Equipment
Z None
Head and Neck
K Musculoskeletal System –
Upper Back / Upper Extremity
L Musculoskeletal System –
Lower Back / Lower Extremity
M Musculoskeletal System –
Whole Body
Let’s break down the character selections as we build our code.
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{
The first three
characters
given to the
coder in the
ICD-10-PCS
Index
September 4, 2015
Vol. 20
Character 1, Section: F Physical Rehabilitation and Diagnostic Audiology
Character 2, Section Qualifier: 0 Rehabilitation
Character 3, Root Type: 8 Activities of Daily Living Treatment: Exercise or activities to facilitate
functional competence for activities of daily living
Character 4, Body System and Region: L Musculoskeletal System -Lower Back / Lower Extremity - This was a calf ulcer
down to muscle tissue, and is therefore deeper than the Integumentary System
Character 5, Type Qualifier: 5 Wound Management – Treatment of the calf ulcer
Character 6, Equipment: B Physical Agents – The wound is being treated by the lavage liquid, a physical agent, not by
mechanical means such as debridement
Character 7, No Qualifier: Z None
Let’s work with a scenario that would fall under category Assessment.
Scenario: Inpatient rehabilitation, patient receiving articulation and phonology assessment using spectrograph F00Z9QZ
ICD-10-PCS Index
Assessment
Speech see Speech Assessment, Rehabilitation F00
Speech Assessment F00
ICD-10-PCS Table
Section
F
Section Qualifier 0
0
Type
Physical Rehabilitation and Diagnostic Audiology
Rehabilitation
Speech Assessment: Measurement of speech and related functions
Body System / Region
Z None
Type Qualifier
9 Articulation/Phonology
Equipment
K Audiovisual
Qualifier
Z None
P Computer
Q Speech Analysis
Y Other Equipment
Z None
Again, let’s break down the character selections as we build our code.
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The first three
characters
given to the
coder in the
ICD-10-PCS
Index
September 4, 2015
Vol. 20
Character 1, Section: F Physical Rehabilitation and Diagnostic Audiology
Character 2, Section Qualifier: 0 Rehabilitation
Character 3, Root Type: 0 Speech Assessment: Measurement of speech and related functions
Character 4, Body System and Region: Z None - None are applicable
Character 5, Type Qualifier: 9 Articulation/Phonology – The definition found in the Definitions section of the ICD-10-PCS
Codebook is, “Measures speech production.”
Character 6, Equipment: Q Speech Analysis - To understand why this selection is made we need to understand what a
spectrograph is, “A sound spectrograph is a laboratory instrument that displays a graphical representation of the strengths of
the various component frequencies of a sound as time passes.”
Character 7, No Qualifier: Z None
Next, let’s work with a scenario that would fall under category Fitting(s).
Scenario: Inpatient rehabilitation, patient receiving individual fitting of moveable brace, right knee. F0DZ6EZ
ICD-10-PCS Index
Device Fitting F0DZ
ICD-10-PCS Table
Section
F
Section Qualifier 0
D
Type
Physical Rehabilitation and Diagnostic Audiology
Rehabilitation
Device Fitting: Fitting of a device designed to facilitate or support achievement of a higher level
Body System / Region
Z None
Type Qualifier
Equipment
6 Dynamic Orthosis
E Orthosis
7 Static Orthosis
F Assistive, Adaptive,
8 Prosthesis
Supportive or Protective
9 Assistive, Adaptive,
U Prosthesis
Supportive or Protective
Z None
Qualifier
Z None
Devices
Once more, let’s break down the character selections as we build our code.
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The first four
characters
given to the
coder in the
ICD-10-PCS
Index
{
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Character 1, Section: F Physical Rehabilitation and Diagnostic Audiology
Character 2, Section Qualifier: 0 Rehabilitation
Character 3, Root Type: D Device Fitting: Fitting of a device designed to facilitate or support
achievement of a higher level of function
Character 4, Body System and Region: Z None - None are applicable
Character 5, Type Qualifier: 6 - Dynamic Orthosis The information found in the Definitions section of the ICD-10-PCS
Codebook is, “Includes/Examples: Includes customized and prefabricated splints, inhibitory casts, spinal and other braces,
and protective devices allows motion through transfer of movement from other body parts or by use of outside forces.”
Character 6, Equipment: E - Orthosis An “orthosis” is an orthopedic appliance or apparatus, such as a brace, used to
support or assist movement of a weak or injured part of the body; or to align, prevent, or correct deformities; or to improve
function of movable parts of the body.
Character 7, No Qualifier: Z None
Finally, let’s work with a scenario that would fall under category Caregiver Training.
Scenario: Caregiver training in feeding, no special equipment used F0FZ2ZZ
ICD-10-PCS Index
Caregiver Training F0FZ
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ICD-10-PCS Table
Section
F
Section Qualifier 0
F
Type
Physical Rehabilitation and Diagnostic Audiology
Rehabilitation
Caregiver Training: Training in activities to support patient’s optimal level of function
Body System / Region
Type Qualifier
Z None
Equipment
0 Bathing/Showering Technique
E Orthosis
1 Dressing
F Assistive, Adaptive,
2 Feeding and Eating
Supportive or Protective
3 Grooming/Personal Hygiene
U Prosthesis
4 Bed Mobility
Z None
Qualifier
Z None
5 Transfer
6 Wheelchair Mobility
7 Therapeutic Exercise
8 Airway Clerance Techniques
9 Wound Management
B Vocational Activities and
Functional Community or
Work Reintegration Skills
C Gait Training/Functional Ambulation
D Application, Proper Use and Care of
Devices
F Application, Proper Use and Care of
Orthoses
G Application, Proper Use and Care of
Prosthesis
{
H Home Management
For a final time, let’s break down the character selections as we build our code.
The first four
characters
given to the
coder in the
ICD-10-PCS
Index
Character 1, Section: F Physical Rehabilitation and Diagnostic Audiology
Character 2, Section Qualifier: 0 Rehabilitation
Character 3, Root Type: F Caregiver Training: Training in activities to support
patient's optimal level of function
Character 4, Body System and Region: Z None - None are applicable
Character 5, Type Qualifier: 2 Feeding and Eating ICD-10-PCS Definition: Exercise or activities to facilitate setting up
food, selecting and using utensils and tableware, bringing food or drink to mouth, cleaning face, hands, and clothing, and
management of alternative methods of nourishment
Character 6, Equipment: Z None
Character 7, No Qualifier: Z None
Note: The coder must be guided by documentation in the medical record of each individual case to make the correct code
selections.
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