ICD-10-PCS codes can be helpful in answering the scope question. The fifth character indicates the approach to reach the operative procedure site: ICD-10-PCS code for fifth character indicates the approach ICD-10 5th Character Approach NHSN Scope Designation 0 Open NO 3 Percutaneous (Included only in CRAN and VSHN categories- procedures with BURR holes) NO 4 Percutaneous endoscopic YES 7 Via natural or artificial opening NO 8 Via natural or artificial opening with endoscopic NO F Via natural or artificial opening with percutaneous endoscopic assistance YES   If the fifth character of the ICD-10-PCS procedure code is a four (4) or F, then the field for scope should be YES.