Are You Stuck Selecting the PCS Qualifier for Detachments?  Read On!

One of the root operations in ICD-10-PCS is detachment. Detachment is defined as cutting off all or part of the upper or lower extremities. Examples of detachments are below knee amputation and disarticulation of the shoulder.

When selecting an ICD-10-PCS code for detachment of the upper arm and/or the upper leg, the coder will need to specify the seventh character, the qualifier, as high 1, mid 2, or low 3. From the ICD-10-PCS Reference Manual (downloadable here), we learn the definitions of these qualifiers. The definitions of each of these levels are:

Upper arm and upper leg

  1. High: Amputation at the proximal portion of the shaft of the humerus or femur
  2. Mid: Amputation at the middle portion of the shaft of the humerus or femur
  3. Low: Amputation at the distal portion of the shaft of the humerus or femur

In order to determine the exact location of the amputation of the shaft of the humerus, femur, radius/ulna, or tibia/fibula it may be necessary to query the physician as this piece of information may not be disclosed in the medical record. (This would be a great educational opportunity to let the physicians know about the need for this piece of information in order to code amputations with ICD-10!)