ICD-10-PCS GUIDELINE/ CODE CHANGES

[Pages:11]ICD-10-PCS GUIDELINE/ CODE CHANGES

2016 TO 2017

9/13/16

75,789 TOTAL PCS CODES

? Medical, Surgical, Administration, Measurement and Monitoring, Extracorporeal Therapies , and New Technology all have changes

? As expected ? Guideline changes too

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THE SPECIFICS

? 3651 New Codes ? 487 Revised codes ? 2 Root operations revisited--Control and Creation ? 1 new Root Operation-- Perfusion--Now we have

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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.

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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

9/13/16

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."

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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!

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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

? 0211093

? Bypass, Coronary Artery, Two Sites from Coronary Artery w/ Autologous Venous Tissue, Open Approach

? This Year

? 0211093

? Bypass Coronary Artery, Two Arteries from Coronary Artery with Autologous Venous Tissue, Open Approach

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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

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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.

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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)

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