ICD-10-PCS GUIDELINE/ CODE CHANGES
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1 ICD-10-PCS GUIDELINE/ CODE CHANGES 2016 TO ,789 TOTAL PCS CODES Medical, Surgical, Administration, Measurement and Monitoring, Extracorporeal Therapies, and New Technology all have changes As expected Guideline changes too 1
2 THE SPECIFICS 3651 New Codes 487 Revised codes 2 Root operations revisited Control and Creation 1 new Root Operation Perfusion--Now we have 32!! FOCUS ON GUIDELINES FIRST B2.1a through B4.4 B2.1a Change was a should to a can for general anatomical regions when a procedure is performed on an anatomical region rather than a body part; The procedure codes in the general anatomical regions body systems CAN be used.... Chest tube drainage of pleural cavity codes to Drainage in general anatomical regions body system and Suture repair of abdominal wall is coded to Repair, general anatomical regions B3.2 New examples of multiple procedures---extraction of multiple toenails are coded separately and Excision of lesion in the ascending colon and transverse colon, also separately. 2
3 GUIDELINES B3.4a Example Clarified FNA Bx of FLUID IN THE lung is coded to root operation Drainage with the Qualifier of Diagnostic. Bx of bone marrow is coded to the root operation Extraction, also Diagnostic Lymph node sampling for Bx is coded to the root operation Excision, also Diagnostic PCS CODING GUIDELINE CHANGES B3.6b Change in language from coronary sites to coronary arteries B3.6c If multiple coronary arteries are bypassed (eliminated the word sites ) B3.7 Change in definition of Control to include Stopping or attempting to stop, post procedural or other acute bleeding. 3
4 GUIDELINE CHANGES B3.9 If an autograft is obtained from a different procedure site separate procedure is coded Used to say different body part B4.2 Branches of body parts New Example: Occlusion of the bronchial artery is coded to the Upper Artery in the body system Upper Arteries, and NOT to the body part value Thoracic Aorta, Descending, in Heart and Great Vessels. Why? In CV, if a general body part is available in the correct root operation table, and coding to a proximal branch goes to another body system, don t go there! CORONARY ARTERIES B4.4 Coronary arteries are classified by number of arteries treated ---Used to say number of sites treated and not by name or number of arteries. Dilation of Coronary Arteries, Two Arteries, w/ Intraluminal Device Dilation of Coronary Artery, One Artery with Intraluminal Device and Dilation of Coronary Artery, One Artery with no device. Wording changes! 4
5 CORONARY ARTERIES One procedure code specifying multiple arteries is used when the same procedure is performed, including same device and qualifier values Separate codes are used if multiple sites in the coronary arteries Examples: Angioplasty 2 distinct arteries in the LAD coronary artery, w 2 stents: Dilation of Coronary Arteries, 2 Arteries, w/ Intraluminal device Angioplasty of 2 distinct arteries in the LAD, one with stent and one without, coded separately EXAMPLE OF NEW LANGUAGE, SAME CODE Last Year Bypass, Coronary Artery, Two Sites from Coronary Artery w/ Autologous Venous Tissue, Open Approach This Year Bypass Coronary Artery, Two Arteries from Coronary Artery with Autologous Venous Tissue, Open Approach 5
6 NEW DEFINITION OF CONTROL Control is now defined as, Stopping, or attempting to stop, post procedural or other acute bleeding. Guideline B3.7 has same language go to one of 7 others first instead of Control. Example is the same Resection of spleen to stop bleeding is coded to Resection instead of Control Coders should be consistent CREATION Definition: Putting in or on biological or synthetic material to form a new body part that, to the extent possible, replicates the anatomic structure or function of an absent body part Explanation: Yes, gender reassignment, but also now corrective procedures in individuals with congenital anomalies Example: Creation of R and L atrioventricular valve from common atrioventricular valve 6
7 PERFUSION Used in Sec 6 Extracorporeal Therapies Example: Extracorporeal treatment by diffusion of therapeutic fluid NEW TECHNOLOGY SECTION X Root Operations Assistance, Fusion, Insertion, Removal, Replacement, Reposition, Revision Approaches include via natural or artificial opening; or Via Natural or Artificial Opening Endoscopic Assistance is taking over a portion of a physiological function by extracorporeal means Example is skin substitute, Porcine liver wound matrix product from porcine liver. Used to management wounds, diabetic foot, venous and pressure ulcers, surgical and traumatic wounds. 7
8 INDEX ADDITIONS: BODY PARTS Thoracic Aorta, Ascending/ Arch Thoracic Aorta, Descending Base of tongue-see Pharynx Bronchus Intermedius: See Main Bronchus, Right Pulmonary Artery Pulmonary Trunk Intermediate Bronchus-see Main Bronchus, Right Internal Carotid Artery, intracranial portion Use Intracranial artery INDEX CORRECTIONS Conization, cervix See Excision, Cervix (not uterus) Levator ani muscle See Perineum Muscle Ophthalmic Artery----Use Intracranial Artery Ossicular Chain Deleted Subcostal artery---use Upper Artery (not thoracic) 8
9 CORRECTED AND NEW TABLES Lots of them Too many to list Examples 024 Heart and Great Vessels, Creation 0X3 Anatomical regions, Upper Extremities, Control 6AB Physiological Systems, Perfusion CARDIOVASCULAR CHANGES Changed Coronary Artery Site/Sites to Coronary Arteries Changed Thoracic Aorta to Thoracic Aorta, Ascending/Arch and Thoracic Aorta, Descending Added Pulmonary Vein, L and R and Confluence Added Device: Intracardiac Pacemaker, Zooplastic Tissue Added Device detail to specific the number of stents used when treating coronary arteries 9
10 MORE CARDIOVASCULAR In Bypass, new rows for Pulmonary Trunk, Pulmonary Artery, L and R and for Thoracic Aorta, Descending and Ascending/Arch New table for Creation 024 Added rows for various valves in Repair and Supplement At qualifier, added bifurcation if not already there New device, Intracardiac pacemaker, directly implanted in R ventricle, small, no leads, fully self contained. Read up on it! FACE TRANSPLANT First Academy question! Now reality! 0WY Anatomical Regions, General, Transplantation Body Part 2 Face Approach Open Device No device Qualifier 0 Allogeneic 1 Syngeneic 0WY2020 or 0WY
11 KEEP LEARNING Lots to learn Google constantly Have fun learning! The best predictor of future behavior is past behavior Thank you for participating! 11
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