ICD-10-PCS Guidelines: A Case Study Approach

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ICD-10-PCS Guidelines: A Case Study Approach



Correct understanding and application of ICD-10-PCS guidelines are essential to anyone concerned with accurate, complete, and defensible coding of inpatient procedures. Using a case study approach, the learner will code over 25 commonly performed inpatient procedures which illustrate the application of multiple guidelines, applied together.

CEUs:  3    3 AHIMA    3 AAPC
Included in eLearning Library. Price per person. Group rates available.

Product Description

Correct understanding and application of ICD-10-PCS guidelines are essential to anyone concerned with accurate, complete, and defensible coding of inpatient procedures. Using a case study approach, the learner will code over 25 commonly performed inpatient procedures which illustrate the application of multiple guidelines, applied together.

Great for coders new to ICD-10-PCS, Clinical Documentation Improvement Specialists, or anyone interested in knowing more about the guidelines that guide code selection for inpatient procedures. Adherence to these guidelines when assigning ICD-10-PCS procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA).

ICD-10-PCS Guidelines:  A Case Study Approach provides a comprehensive review of ICD-10-PCS Guidelines and demonstrates how to apply the guidelines in code assignment:

  • Using a step-by-step approach, over 25 cases with up to four applicable guidelines each, illustrate how to apply multiple guidelines together
  • Documentation is key. Learn how to identify missing information or determine if documentation needs to be clarified by the surgeon prior to code assignment ensuring accurate reporting and reimbursement
  • Complex guideline challenges are included
    • Spinal surgery, both fusions and release procedures
    • Coronary artery bypass procedures using a variety of devices
    • Use of Section X codes
    • Breast replacement versus transfer reconstruction
    • The Control guideline
    • Assistance with principal procedure guideline application

There is always more to learn in coding! If mastering ICD-10-PCS is on your ‘to-do’ list, consider Libman Education’s eLearning Library: Inpatient Coding. An affordable option that offers on-demand access to mastery-level courses to enhance job-specific, self-paced learning for one full year.

ICD-10-PCS Guidelines:  A Case Study Approach provides a comprehensive review of ICD-10-PCS Guidelines and demonstrates how to apply the guidelines in code assignment:

Lesson 1
Guidelines A1-A9
Case Study 1 – Shoulder Joint Aspiration and Percutaneous Drainage Tube Insertion
Case Study 2 – Layered closure of left lower leg laceration
Case Study 3 – Coil occlusion of left vertebral artery aneurysm
Case Study 4 – Closed reduction of right mandibular fracture and tooth extraction
Case Study 5 – Laparoscopic-assisted sigmoidectomy
Case Study 6 – Placement of REBOA and repair of abdominal aorta
Case Study 7 –Thrombectomy of coronary artery bypass graft
Case Study 8 – Vaginal delivery with episiotomy and laparoscopic tubal occlusion

Lesson 2
Guidelines B3.1a – B3.18
Case Study 1 – Endoscopic control of gastric ulcer with endo-clips
Case Study 2 – Endoscopic examination of stomach and suture repair of stomach via laparoscopy
Case Study 3 – Right middle and lower lobectomy lung
Case Study 4 – Diagnostic lumbar puncture
Case Study 5 – Failed diagnostic lumbar puncture
Case Study 6 – Coronary artery bypass grafts x 3
Case Study 7 – Coronary atherectomy and angioplasty with stent placement
Case Study 8 – Open reduction and internal fixation of tibia shaft fracture
Case Study 9 – Decompression laminectomy C5-C7
Case Study 10 – Left mastectomy with DIEP flap reconstruction
Case Study 11 – Percutaneous allogeneic bone marrow transplant
Case Study 12 – Left below knee amputation

Lesson 3
Guidelines B2.1a – B2.1b; B4.1a – B4.8; F Selection of Principal Procedure
Case Study 1 – Suture repair of finger tendons and layered laceration repair
Case Study 2 – Chest tube insertion and talc pleurodesis
Case Study 3 – Percutaneous thrombectomy right dorsalis pedis and posterior tibial arteries
Case Study 4 – Percutaneous exchange of jejunostomy tube
Case Study 5 – Kyphoplasty T12 and L1
Case Study 6 – Spinal fusion with interbody fusion device T12-L2
Case Study 7 – Destruction skin lesions bilateral thumbs
Case Study 8 – Open excision of greater curvature stomach tumor
Case Study 9 – Reconstruction nasal tip with forehead paramedian skin flap
Case Study 10 – Prostatectomy with insertion of brachytherapy element
Case Study 11 – Left heart catheterization with coronary angiograms and ventriculogram followed by coronary artery bypass

The level of effort to complete this course, start to finish, is equivalent to 3 CEUs and should take you approximately 3-9 hours to complete. Remember: You have access to the course materials for the full 16-week enrollment period and we encourage you to re-review any materials that are helpful to you.

Certificate of Completion
Upon successful completion of the course work, student will be able to download a Libman Education Certificate of Completion. The Certificate of Completion will list the course as awarding 3 CEUs.

This course has been approved for continuing education units (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.

This program has the prior approval of AAPC for continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

  • WebinarPlus™ multimedia and interactive online course promotes engagement with challenging materials while offering independent self-study.
  • Teaching methods including audio and video files, diagrams, and animations to accommodate different learning styles. Where appropriate, the Merck Manual Professional Version supplements course materials with in-depth descriptions of diagnoses and/or procedures.
  • Knowledge checks and/or final assessment ensure mastery of material.
  • Online Flexibility! Materials available via secure Learning Management System (LMS). Work at your own pace — save time and travel costs.
  • Earn Libman Education Certificate of Completion and CEUs.
  • To receive CEU credit, students must achieve a passing rate on the course assessment(s).
  • Course is self-paced. For planning purposes, assume 1-3 hours required for each CEU.
  • Unlimited course access during enrollment period. For courses offering greater than one CEU, enrollment period is 16 weeks. For courses offering one or fewer CEUs, enrollment period is 4 weeks. Courses purchased as a bundle or package may have a longer enrollment period.
  • Extensions to the enrollment period are available. Contact Libman Education for pricing.
  • Price listed is per person/per course. Group rates available upon request.


Lynn Kuehn is president of Kuehn Consulting, LLC, and a nationally recognized authority on ICD-10-PCS coding.

Lynn was elected to the AHIMA Board of Directors, served as faculty for the original ICD-10 “Train-the-Trainers” program, and authored or co-authored several of AHIMA’s most popular books including ICD-10-PCS: An Applied Approach, recognized as the “go-to” resource for learning and mastering ICD-10-PCS.

As a Subject Matter Expert with Libman Education, Lynn’s unique and engaging teaching methods as well as her leadership on the importance of accuracy and efficiency in coding is recognized by clients and students throughout the country.

“Lynn Kuehn is the best in the country with PCS coding.” — Roberta Walker, Inpatient Coding Educator at Hawaii Pacific Health

“I have known Lynn a long time and I’ve been working with coders and those external auditors who audit coding for over 40 years. Lynn is not only the best at PCS coding but also with the Anatomy and Physiology that are involved to better understand what goes on in complex operations.” — Roberta Walker, Inpatient Coding Educator at Hawaii Pacific Health

“Lynn Kuehn, in my mind, is the Queen of Coding Education. She has the ability to take a difficult, confusing subject and make it very easily understood.” — Charlotte Bumgarner

“Lynn is an inspirational teacher. She ignites a passion for coding within you!” — Kristen T

“Lynn, your explanations are clear, concise and to the point. Recommend it to any and all. It is a confidence booster!” — Leslie C

“I consistently learn from Lynn Kuehn. Thank you!”

“Lynn: I look for everything you have on the internet. You have a wonderful concise way of presenting material that is so easy to understand. All of us learn differently and your slides help us ‘Visual learners.’ keep up the great work. I will be ordering your flash cards! Many thanks.”

“Any of Libman Education’s courses are worth time and cost. Always walk away with a useable, clarity or reinforcement of subject matter.”

“I just wanted to let you know that the articles written by Lynn are a great help. I read them all the time and learn something new each time. Please let her know what a fine job she does.” — Kira G., RHIT, IP Coder III

“Lynn always has a way of getting the information across in a simple, understandable way!” — Janice N.

“Just heard Gail and Lynne’s PCS workshop – fantastic information and terrific speakers!!” — Jacqueline F., RHIT, CCS, DRG Validation Specialist


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Recommended Resources:

  • ICD-10-PCS Code Book – 2022 or students may elect to use electronic files
  • ICD-10-PCS: An Applied Approach by Lynn Kuehn and Teri Jorwic is published by the American Health Information Management Association. While AHIMA is not publishing a 2022 edition, the 2021 edition has been supplemented with a “2022 Update Document” in the Student Resources (accessed using the information inside the front cover of the text). The book is available for purchase from AHIMA here and Amazon here. 2023 version coming this November.
  • Medical dictionary
  • Anatomy and physiology reference
  • Merck Manual

Learning Aids:

ICD-10 Root Operations Flash CardsRoot Operation Flash Cards

This set of nine 5×7, laminated, double-sided ICD-10-PCS Root Operations Flash Cards, designed by nationally recognized ICD-10 expert Gail I. Smith, MA, RHIA, CCS-P, prepares you to select the appropriate root operation with confidence.


Approach Decision Tree Flash Cards

The ICD-10-PCS Approach Decision Tree, developed by nationally recognized ICD-10-PCS expert, Lynn Kuehn, is a two-sided, laminated flashcard providing both the approach decision tree plus definitions of the seven different approaches in a handy, easy-to-use format.

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