Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education Chapter 19 Imaging through Substance Abuse Treatment Sections (B–H)

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Objectives LO 19.1 Recognize the details reported in other sections of ICD-10-PCS beyond the Medical and Surgical section. LO 19.2 Evaluate the details to determine the section from which to code. LO 19.3 Determine the body system or region being treated. 19-2

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Objectives (cont.) LO 19.4 Interpret the procedure to determine the accurate root operation or procedure term. LO 19.5 Utilize knowledge of anatomy to determine the body part treated. LO 19.6 Identify the approach used to access the body part. 19-3

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Objectives (cont.) LO 19.7 Distinguish the type of device implanted, or other qualifier, when applicable. LO 19.8 Select the appropriate qualifier character. 19-4

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms Densitometry High Osmolar Intravascular Optical Coherence Low Osmolar 19-5

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Introduction Last six sections of ICD-10-PCS focus on coding for services provided by imaging professionals, rehabilitation specialists, audiologists, and mental health/behavioral health professionals. 19-6

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Imaging Section 19-7

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Imaging Section B All of the codes from this section will begin with the letter B Example: BT40ZZZ Ultrasonography urinary bladder 19-8

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System Central Nervous System... Character 0 Heart... 2 Upper Arteries... 3 Lower Arteries... 4 Veins... 5 Lymphatic system

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System (cont.) Eye... 8 Ears, Nose, Mouth, and Throat... 9 Respiratory system... B Gastrointestinal system... D Hepatobiliary system... F Endocrine system... G 19-10

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System (cont.) Skin, Subcutaneous Tissue and Breast... H Connective Tissue... L Skull and Facial Bones... N Non-Axial Upper Bones... P Non-Axial Lower Bones... Q 19-11

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System (cont.) Axial skeleton, except skull and facial bones... R Urinary System... T Female reproductive System... U Male reproductive System... V Anatomical regions... W Fetus and obstetrical... Y 19-12

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type Plain Radiography (x-ray)... Character 0 Fluoroscopy... 1 Computerized Tomography (CT scan)... 2 Magnetic Resonance Imaging (MRI)... 3 Ultrasonography

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Part From the brain to the toes, each body part is listed, specific to the body system in conjunction with the root type 19-14

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Contrast High Osmolar... Character 0 Low Osmolar... 1 Other Contrast... Y None... Z 19-15

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Qualifier Unenhanced and Enhanced... Character 0 Laser... 1 Intravascular Optical Coherence... 2 None... Z 19-16

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Intraoperative... Character 0 Densitometry... 1 Intravascular... 3 Transesophageal... 4 Guidance... A None... Z 19-17

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Nuclear Medicine Section 19-18

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Nuclear Medicine Section C Describe the use of radioactive material administered into the patient’s body to enable the creation of an image for further study Example: CV191ZZ Planar Nuclear Medicine imaging, bilateral testicles, Technetium 99m 19-19

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System Character descriptors of body systems in this section are those with which you have become familiar in this code set 19-20

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type Planar Nuclear Medicine Imaging: Introduction of radioactive materials into the body for single-plane display of images developed from the capture of radioactive emissions... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Tomographic (Tomo) Nuclear Medicine Imaging: Introduction of radioactive materials into the body for three-dimensional display of images developed from the capture of radioactive emissions... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Positron Emission Tomographic (PET) Imaging: Introduction of radioactive materials into the body for three-dimensional display of images developed from the simultaneous capture, 180 degrees apart, of radioactive emissions... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Nonimaging Nuclear Medicine Uptake: Introduction of radioactive materials into the body for measurements of organ function, from the detection of radioactive emissions... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Nonimaging Nuclear Medicine Probe: Introduction of radioactive materials into the body for the study of distribution and fate of certain substances by the detection of radioactive emissions; or alternatively, measurement of absorption of radioactive emissions from an external source... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Nonimaging Nuclear Medicine Assay: Introduction of radioactive materials into the body for the study of body fluids and blood elements, by the detection of radioactive emissions... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Systemic Nuclear Medicine Therapy: Introduction of unsealed radioactive materials into the body for treatment... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Part The list of body parts or systems is similar to the list shown in the Imaging section such as Ear, Nose, Mouth, and Throat—as well as regions—such as Lower Extremity Veins, Right—are included along with specific body parts, such as thyroid gland and spleen

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Radionuclide The options in this list include the descriptors of radioactive materials—the source of the radiation 19-29

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Radionuclide (cont.) Technetium 99m (Tc-99m)... Character 1 Cobalt 58 (C0-58)... 7 Samarium 153 (Sm-153)... 8 Krypton (Kr-81m)... 9 Carbon 11 (C-11)... B Cobalt 57 (Co-57)... C 19-30

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Radionuclide (cont.) Indium 111 (In-111)... D Iodine 123 (I-123)... F Iodine 131 (I-131)... G Iodine 125 (I-125)... H Fluorine 18 (F-18)... K Gallium 67 (Ga-67)... L 19-31

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Radionuclide (cont.) Oxygen 15 (O-15)... M Phosphorus 32 (P-32)... N Strontium 89 (Sr-89)... P Rubidium 82 (Rb-82)... Q Nitrogen 13 (N-13)... R Thallium 201 (Tl-201)...S 19-32

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Radionuclide (cont.) Xenon 127 (Xe-127)... T Xenon 133 (Xe-133)... V Chromium (Cr-51)... W Other Radionuclide... Y None... Z 19-33

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Qualifier The Nuclear Medicine section has only one option for the character reported in the sixth position: None... Character Z

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier There are no details reported by the Qualifier position –None... Character Z is the only option 19-35

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Radiation Oncology Section 19-36

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Radiation Oncology Section D Procedures reported from the Radiation Oncology section will all begin with the letter D Example: DB22HZZ Stereotactic Particulate Radiosurgery, Lung 19-37

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System This list is very similar to other sections for body system 19-38

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type Four root types are used to describe the modality of these procedures –Beam Radiation: Character 0 –Brachytherapy: Character 1 –Stereotactic Radiosurgery: Character 2 –Other Radiation: Character Y 19-39

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Treatment Site Note: The same character is used to identify different body parts throughout this section It changes from body system to body system 19-40

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Modality Qualifier Photons <1 MeV... Character 0 Photons 1–10 MeV... 1 Photons >10 MeV... 2 Electrons... 3 Heavy Particles (Protons, Ions)... 4 Neutrons

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Modality Qualifier (cont.) Neutron Capture... 6 Contact Radiation... 7 Hyperthermia... 8 High Dose Rate (HDR)... 9 Low Dose Rate (LDR)... B Intraoperative Radiation Therapy (IORT)... C 19-42

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Modality Qualifier (cont.) Stereotactic Other Photon Radiosurgery... D Plaque Radiation... F Isotope Administration... G Stereotactic Particulate Radiosurgery... H Stereotactic Gamma Beam Radiosurgery... J Laser Interstitial Thermal Therapy... K 19-43

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Isotope Identify the specific radioactive substance used during this procedure –Cesium 137 (Cs-137)... Character 7 –Iridium 192 (Ir-192)... 8 –Iodine 125 (I-1250)... 9 –Palladium 103 (Pd-103)... B –Californium 252 (Cf-252)... C –Iodine 131 (I-131)... D 19-44

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Isotope (cont.) Identify the specific radioactive substance used during this procedure (cont.) –Phosphorus 32 (P-32) … F –Strontium 89 (Sr-89)... G –Strontium 90 (Sr-90)... H –Other Isotope... Y –None... Z 19-45

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Positon 7: Qualifier This character will report whether this radiation treatment was provided during a surgical procedure –Intraoperative... Character 0 –No Qualifier... Z 19-46

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Physical Rehabilitation and Diagnostic Audiology Section 19-47

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Positon 1: Physical Rehabilitation and Diagnostic Audiology Section F Procedures reported from this section begin with the letter F Example: F13Z31Z Bekesy Audiometry 19-48

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Section Qualifier There are only two options for the second character –Rehabilitation... Character 0 –Diagnostic Audiology... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type Speech Assessment... Character 0 Monitor and/or Nerve Function Assessment... Character 1 Activities of Daily Living Assessment... Character 2 Hearing Assessment... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Hearing Aid Assessment... Character 4 Vestibular Assessment... Character 5 Speech Treatment... Character 6 Motor Treatment... Character 7 Activities of Daily Living Treatment... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Hearing Treatment... Character 9 Cochlear Implant Treatment... Character B Vestibular Treatment... Character C Device Fitting... Character D Caregiver Training... Character F 19-52

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body System & Region The specific body system being assessed or rehabilitated will be identified in this character position Unspecified area reported with None... Character Z 19-53

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Type Qualifier The character placed in this position will provide additional detail about the root type 19-54

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Equipment Report any equipment that was used during the assessment or treatment 19-55

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Only option in this position is None... Character Z 19-56

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Mental Health Section 19-57

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Mental Health Section G Procedures reported from this section will begin with the letter G Example: GZ11ZZZ Personality and Behavioral Psychological Tests 19-58

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System There is only one option for the second character –None... Character Z 19-59

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type 12 root types used in this section –Psychological Tests: Include developmental, intellectual, psychoeducational, neurobehavioral, cognitive, neuropsychological, personality, and/or behavioral testing... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Crisis Intervention: Includes defusing, debriefing, counseling, psychotherapy, and/or coordination of care with other providers or agencies... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Medication Management... Character 3 –Individual Psychotherapy: Includes behavior, cognitive, interactive, interpersonal, psychoanalysis, psychodynamic, psychophysiological, and/or supportive... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Counseling: Exploration of vocational interest, aptitudes, and required adaptive behavior skills to develop and carry out a plan for achieving a successful vocational placement, enhancing work-related adjustment, and/or pursuing viable options in training education or preparation... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Family Psychotherapy: Remediation of emotional or behavioral problems presented by one or more family members when psychotherapy with more than one family member is indicated...Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Electroconvulsive Therapy: Includes appropriate sedation and other preparation of the individual... Character B 19-65

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Biofeedback: Includes electroencephalogram (EEG), blood pressure, skin temperature, or peripheral blood flow, electrocardiogram (ECG), electrooculogram, electromyogram (EMG), respirometry or capnometry, galvanic skin response (GSR) or electrodermal response (EDR), perineometry to monitor and regulate bowel or bladder activity and electrogastrogram to monitor and regulate gastric motility... Character C 19-66

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) 12 root types used in this section (cont.) –Hypnosis... Character F –Narcosynthesis... Character G –Group Psychotherapy... Character H –Light Therapy... Character J 19-67

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Type Qualifier This character will explain whether the procedure was educational or vocational 19-68

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Qualifier Only one option in this position – None... Z 19-69

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Qualifier Only one option in this position – None... Z 19-70

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Only one option in this position – None... Z 19-71

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Substance Abuse Treatment Section 19-72

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Substance Abuse Section H Procedures reported from this section will all begin with the letter H Example: HZ48ZZZ Substance Abuse group counseling, vocational 19-73

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body Systems Only one option in this position – None... Character Z 19-74

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type Seven root operation terms –Detoxification Services: Not a treatment modality but helps the patient stabilize physically and psychologically until the body becomes free of drugs and the effects of alcohol... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Seven root operation terms (cont.) –Individual Counseling: Comprising several techniques, which apply various strategies to address drug addiction... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Seven root operation terms (cont.) –Group Counseling: Provides structured group counseling sessions and healing power through the connection with others...Character 4 –Individual Psychotherapy:... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Type (cont.) Seven root operation terms (cont.) –Family Counseling: Provides support and education for family members of addicted individuals. Family member participation seen as critical to substance abuse treatment... Character 6 –Medication Management:... Character 8 –Pharmacotherapy:... Character

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Type Qualifier This character will add detail to the description of the Root Type 19-79

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Qualifier Only one option in this position – None... Character Z 19-80

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Qualifier Only one option in this position – None... Character Z 19-81

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Only one option in this position – None... Character Z 19-82

Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chapter Summary Each character position is important to reporting all of the pertinent details of a procedure, service, or treatment. The same character can have a different meaning in each section. The tables are there to provide the options and their meanings to build the accurate code