FY 2017 ICD-10-PCS Code Updates Webinar 6 Presented by: Maria Ward, MEd, RHIT, CCS-P Director, HIM Practice Excellence, AHIMA
Agenda ICD-10-PCS Table Changes Coding Examples Key Definitions Video Examples
Flourescence Vascular Angiography (FVA) Indocyanine Green Dye (ICG Dye) Diagnostic Dye Plasma protein binding Allows for visualization of blood flow Used for Liver function Cardiac output Ophthalmic angiography
Currently 3E033KZ Introduction of Other Diagnostic Substance into Peripheral Vein, Percutaneous Approach 3E043KZ Introduction of Other Diagnostic Substance into Central Vein, Percutaneous Approach But for 2017
Table 4A1 Section Body System Operation 4 Measurement and Monitoring A Physiological Systems 1 Monitoring: Determining the level of a physiological or physical function repetitively over a period of time Body System Approach Function/Device Qualifier 2 Cardiac 0 Open 3 Percutaneous 4 Electrical Activity 9 Output C Rate F Rhythm H Sound Z No Qualifier 2 Cardiac X External 4 Electrical Activity 5 Ambulatory Z No Qualifier 2 Cardiac X External 9 Output C Rate F Rhythm H Sound Z No Qualifier 2 Cardiac X External M Total Activity 4 - Stress 2 Cardiac X External S Vascular Perfusion H Indocyanine Green Dye
Table 4A1 (cont) Section Body System Operation 4 Measurement and Monitoring A Physiological Systems 1 Monitoring: Determining the level of a physiological or physical function repetitively over a period of time Body System Approach Function/Device Qualifier B - Gastrointestinal 7 Via Natural or Artificial Opening 8 Via Natural or Artificial Opening Endoscopic 8 Motility B Pressure G - Secretion Z No Qualifier B - Gastrointestinal X External S Vascular Perfusion H Indocyanine Green Dye
Activity: ICG Flourescence Watch the following video ICG Flourescence Angiogram of Ileoanal J Pouch
Table 4A1 (cont) Section Body System Operation 4 Measurement and Monitoring A Physiological Systems 1 Monitoring: Determining the level of a physiological or physical function repetitively over a period of time Body System Approach Function/Device Qualifier G Skin and Breast X External S Vascular Perfusion H Indocyanine Green Dye
Table 6AB Section Body System Operation 6 Extracorporeal Therapies A Physiological Systems B Perfusion: Extracorporeal treatment by diffusion of therapeutic fluid Body System Duration Qualifier Qualifier 5 Circulatory B Respiratory System F Hepatobiliary System and Pancreas T Urinary System 0 Single B Donor Organ Z No Qualifier
Coding Example A 30 year old male patient needs a right lung transplant. When a donor lung becomes available, it will be maintained at the normal body temperature and treated with a solution that contains oxygen, nutrients, and proteins as a means to reduce any lung injury. Code for the procedure described on the donor lung.
Coding Example Answer 6ABB0BZ - Perfusion of Respiratory System Donor Organ, Single Section 6 Extracorporeal Therapies Body System A Physiological Systems Operation B Perfusion: Extracorporeal treatment by diffusion of therapeutic fluid Body System B Respiratory System Duration 0 Single Qualifier B Donor Organ Qualifier Z No Qualifier
Table X2A Section Body System Operation X New Technology 2 Cardiovascular System A Assistance: Taking over a portion of a physiological function by extracorporeal means Body Part Approach Device/Substance/ Technology 5 Innominate Artery and Left Common Carotid Artery 3 Percutaneous 1 Cerebral Embolic Filtration, Dual Filter Qualifier 2 New Technology Group 2
Table X2C Section X New Technology Body System 2 Cardiovascular System Operation C Extirpation: Taking or cutting out solid matter from a body part Body Part Approach Device/Substance/ Technology 0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries 3 Percutaneous 6 Orbital Atherectomy Technology Qualifier 1 New Technology Group 1
Table X2R Section Body System Operation X New Technology 2 Cardiovascular System R Replacement: Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part Body Part Approach Device/Substance/ Technology F Aortic Valve 0 Open 3 Percutaneous 4 Percutaneous Endoscopic 3 Zooplastic Tissue, Rapid Deployment Technique Qualifier 2 New Technology Group 2
Table XHR Section Body System Operation X New Technology H Skin, Subcutaneous Tissue, Fascia and Breast R Replacement: Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part Body Part Approach Device/Substance/ Technology P Skin X External L Skin Substitute, Porcine Liver Derived Qualifier 2 New Technology Group 2
Table XNS Section X New Technology Body System N Bones Operation S Reposition: Moving to its normal location, all or a portion of a body part Body Part Approach Device/Substance/ Technology 0 Lumbar Vertebra 3 Cervical Vertebra 4 Thoracic Vertebra 0 Open 4 Percutaneous Endoscopic 3 Magnetically Controlled Growth Rod(s) Qualifier 2 New Technology Group 2
Activity: Magnetically Controlled Growth Rod Watch the following video Magnetically Controlled Growth Rod
Table XRG Section Body System Operation X New Technology R Joints G Fusion: Joining together portions of an articular body part rendering the articular body part immobile Body Part Approach Device/Substance/ Technology 0 Occipital-cervical Joint 1 Cervical Vertebral Joint 2 Cervical Vertebral Joints, 2 or more 4 Cervicothoracic Vertebral Joint 6 Thoracic Vertebral Joint 7 Thoracic Vertebral Joints, 2 to 7 8 Thoracic Vertebral Joints, 8 or more A Thoracolumbar Vertebral Joint B Lumbar Vertebral Joint C Lumbar Vertebral Joints, 2 or more D Lumbosacral Joint 0 Open 9 Interbody Fusion Device, Nanotextured Surface Qualifier 2 New Technology Group 2
Table XW0 Section Body System Operation X New Technology W Anatomical Regions 0 Introduction: Putting in or on a therapeutic, diagnostic, nutritional, physiological, or prophylactic substance except blood or blood products Body Part Approach Device/Substance/ Technology Qualifier 3 Peripheral Vein 3 Percutaneous 2 Ceftazidime-Avibactam Anti-infective 3 Idarucizumab, Dabigatran Reversal Agent 4 Isavuconazole Antiinfective 5 Blinatumomab Antineoplastic Immunotherapy 3 Peripheral Vein 3 Percutaneous 7 Andexanet Alfa, Factor Xa Inhibitor Reversal Agent 9 Defibrotide Sodium Anticoagulant 1 New Technology Group 1 2 New Technology Group 2
XW0 (cont) Section Body System Operation X New Technology W Anatomical Regions 0 Introduction: Putting in or on a therapeutic, diagnostic, nutritional, physiological, or prophylactic substance except blood or blood products Body Part Approach Device/Substance/ Technology Qualifier 4 Central Vein 3 Percutaneous 2 Ceftazidime-Avibactam Anti-infective 3 Idarucizumab, Dabigatran Reversal Agent 4 Isavuconazole Antiinfective 5 Blinatumomab Antineoplastic Immunotherapy 4 Central Vein 3 Percutaneous 7 Andexanet Alfa, Factor Xa Inhibitor Reversal Agent 9 Defibrotide Sodium Anticoagulant 1 New Technology Group 1 2 New Technology Group 2 D Mouth and Pharynx X - External 8 Uridine Triacetate 2 New Technology Group 2
Coding Example Two days ago, Mary received her normal dosage of Adrucil for advanced colon cancer. This morning she awakened with abdominal cramps associated with nausea and vomiting. She noticed that her feet were swollen and the soles were red. Additionally, she felt that there was an eruption of sores in her mouth. Upon calling her oncologist, she immediately had Mary come to the office to receive an oral dose of Vistogard to reverse the effects of the Adrucil. Code for the administration of the Vistogard..
Coding Example Answer XW0DX82 - Introduction of Uridine Triacetate into Mouth and Pharynx, External Approach, New Technology Group 2 Section X New Technology Body System W Anatomical Regions Operation 0 Introduction: Putting in or on a therapeutic, diagnostic, nutritional, physiological, or prophylactic substance except blood or blood products Body Part D Mouth and Pharynx Approach X External Device/Substance/ Technology 8 Uridine Triacetate Qualifier 2 New Technology Group 2
Thank you for joining us for FY 2017 ICD-10-PCS Code Updates Webinar 6!!
ICD-10-PCS Webinar Series Authors Dianna Foley, RHIA, CHPS, CCS - Independent Contractor, Dee Mandley & Associates, Coding Education Coordinator, OHIMA Wahiyda Harding, MSA, RHIA, CCS, CTR - Coding Compliance Auditor, Comforce Kim Kearl, RHIA System Coding Educator, Banner Health Erica Moore, MBA, RHIA, CCS, CPC - Independent Contractor, Optimum Healthcare Consulting Kay Piper, RHIA, CDIP, CCS - Inpatient Coding Educator, St.Louis Network Felicia Thomas, RHIT, CCS, CPC, CPC-I, CCDS - Auditing/Coding Consultant, Opportune IT Angie Comfort, RHIA, CDIP, CCS - Senior Director, HIM Practice Excellence, AHIMA Gina Sanvik, MS, RHIA - Director, HIM Practice Excellence, AHIMA Maria Ward, MEd, RHIT, CCS-P - Director, HIM Practice Excellence, AHIMA
ICD-10 Resources CMS website for ICD-10-CM and ICD-10-PCS files and updates https://www.cms.gov/medicare/coding/icd10/index. html Coordination and Maintenance Committee Meetings https://www.cms.gov/medicare/coding/icd9provider DiagnosticCodes/ICD-9-CM-C-and-M-Meeting- Materials.html CDC Coordination and Maintenance ICD-10-CM Resources http://www.cdc.gov/nchs/icd/icd10cm_maintenance. htm