2024 ICD-10-PCS Codes Released – New Technology Makes Up the Most of the Updates
CMS released the FY 2024 ICD-10-PCS file in June. The Official Guidelines updates include 2024 Tables and Index addenda, as well as reference addenda for the Body Part, Devices, and Substance Keys. With 78 new codes and five deletions, the total number of ICD-10-PCS codes for 2024 is 78,603. There were also 14 code title revisions. All these changes are effective on October 1, 2023.
Two Changes to Official Coding Guidelines
There are no new guidelines in the 2024 update, but there are two changes, one addition, and one deletion. Guideline B5.2b has been renamed Percutaneous endoscopic approach with hand-assistance or extension of incision and has been expanded to include hand-assistance and exteriorization of a body structure. The percutaneous endoscopic approach is used for these circumstances, and an example is provided in the guideline.
The parenthetical examples from guideline B6.1a in the General Guidelines for Devices were removed. This relates to the part of the guideline that discusses the circumstance where a device is intended to be left after the procedure is completed but requires removal before the end of the operative episode. In this case, both the insertion and removal of the device are coded. Two examples found in parentheses, device size is inadequate, and an event documented as a complication occurs, have been removed from the body of the guideline.
Medical and Surgical Section
The Medical and Surgical section includes new codes for the Insertion, Removal, and Revision of Short-term External Heart System. The body part of Larynx is added to the Reposition table for the Mouth and Throat to allow coding of procedures such as repositioning the thyroid cartilage. Codes for Insertion of a Magnetic Lengthening Device for the upper, middle, and lower esophagus are found in the 0DH table for Gastrointestinal System Insertion. New codes for Insertion, Removal, and Revision of Extravascular Implantable Defibrillator Lead in the Mediastinum are available in the General Anatomical Regions.
Medical and Surgical-Related Sections
In the Medical and Surgical-related sections, three new codes are added in the Extracorporeal or Systemic Assistance and Performance for Intubated Prone Positioning for respiratory ventilation, a technique found to be beneficial for patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Ten codes for Fluorescence-guided Surgery using CYTALUX® (Pafolacianine) are available in the Other Procedures section for the Female Reproductive System and the Trunk Region. Pafolacianine is an optical imaging agent used as an adjunct for intraoperative identification of ovarian or lung cancer. The requestor has submitted two New Technology Add-on Payment (NTAP) applications for FY 2024 consideration.
New Technology Codes Responsible for Majority of New Codes
Forty of the new codes for FY 2024 are found in the New Technology section, also known as X codes. As in other updates, these X codes are used for new procedures and the introduction of new substances and devices, and are intended to be temporary.
The 2024 changes include five new tables for Section X, including X05 for Destruction in the Nervous System, Ultrasound Ablation of the Renal Sympathetic Nerve(s). An example of new codes in an existing table is for Fusion of ankle and tarsal joints using an Open-truss Internal Fixation Device, found in the XRG table for fusion of joints.
Nine new substance values are found in the XW0 table for Introduction, for example Glofitamab Antineoplastic, and one new substance, Lovotibeglogene Autotemcel, in table XW1 for Transfusion via peripheral or central vein. These are just some examples of the extensive additions to this section.
NTAP Applications for Majority of New Technology Codes
In that X codes are used for new technology, most of the codes are associated with an application for an additional payment or New Technology Add-on Payment (NTAP) to the MS-DRG reimbursement to help defray the costs for these procedures. As noted, there was also an NTAP application for the codes in the Other Procedures section for Fluorescence-guided Surgery using CYTALUX® (Pafolacianine). Decisions on these and other NTAP applications and the monetary amount for each approved NTAP will be announced in the Final Rule for IPPS, due in July or early August.
Procedure Code Update Presentations
October 1, 2023, will bring many updates to procedure coding. YES HIM Consulting will have three comprehensive presentations to help prepare you and your staff for these changes.
- The ICD-10-PCS Code update presentation will include information on the Medical and Surgical and Medical Surgical-related codes, reference addenda, and Guideline changes.
- The Section X New Technology presentation will offer details on the clinical background and codes for new devices, substances, and procedures found in this section.
- The IPPS update presentation will include information on changes to MS-DRGs, as well as decisions on all 2024 NTAP applications and reimbursement.
Separate presentations on the FY 2024 ICD-10-CM changes will also be available.
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Review our ICD-10 Coding Guidelines and Updates Resource Center for more information about the 2024 ICD-10-PCS changes.
