ICD-10-PCS
Coding rules & edit lists
Code lists from the Medicare Code Editor, MS-DRG definitions and the official code set. These are the edits that make inpatient claims reject or pend.
- Female-only procedure codes2,307Procedures consistent only with female patients.
- Male-only procedure codes1,949Procedures consistent only with male patients.
- Non-covered procedure codes95Procedures Medicare never covers.
- Limited-coverage procedure codes49Procedures Medicare covers only under specific circumstances.