<< Previous Data Element Outpatient Output Table of Contents Next Data Element >>

Data Element Name:   Principal Procedure Code
SPARCS Data Element Number:  52
Record Positions:  1445 - 1451 Format-Length:  A/N - 7
Effective Date:  1/1/1994 Revision Date:  December 1996

Definition:

All significant procedures are to be reported: the Principal Procedure here and other significant procedures in Other Procedure Code 1-14 (Data Element 54).

A significant procedure was surgical in nature, carried a procedural risk, carried an anesthetic risk, or required specialized training. Surgery included incision, excision, amputation, introduction, endoscopy, repair, destruction, suture, and manipulation.

When more than one procedure was reported, the principal procedure was to be designated. In determining which of several procedures was principal, the following criteria applied:

The principal procedure was one that was performed for definitive treatment rather than one performed for diagnostic or exploratory purposes, or was necessary to take care of a complication. If there appeared to be two procedures that were principal, then the one most related to the principal diagnosis should have been selected as the principal procedure.

Codes and Values:
  1. Must have been left justified and entered exactly as shown in the ICD-9-CM coding reference, excluding the decimal point, and space filled.

  2. If this field was not applicable, it contains blanks.
Edit Applications:
  1. Ambulatory Surgery Only:
    a. Edits pertaining to ICD-9-CM codes were validated on the basis of the Discharge Date (Data Element 6) and Expected Principal Reimbursement (Data Element 21) depending on conditions described in Appendix N, which included sex-specific diagnosis code conditions.

    b. If the Principal Procedure Code was entered, the Operating Physician State License Number (Data Element 63) and Principal Procedure Date (Data Element 53) must have also been reported.

  2. Emergency Department Only:
    a. If Operating Room time was greater than zero, then Principal Procedure Code was required.

    b. Edits pertaining to ICD-9-CM codes were validated on the basis of the Discharge Date (Data Element 6) depending on conditions described in Appendix N, which included sex-specific diagnosis code conditions.