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ICD-10-PCS Codes Updates – FY2019

ICD-10-PCS Codes Updates – FY2019

The Centers for Medicare and Medicaid Services (CMS) released the 2019 ICD-10-PCS code changes for fiscal year(FY) 2019. After the codes are approved in the FY 2019 IPPS Final Rule, they will be implemented by all hospital inpatient coding professionals with discharges occurring on October 1, 2018.

Codes

According to the CMS FY 2019 Update Summary, there are 392 new codes, 8 revised codes and 216 deleted codes. For FY 2019 there will be 78,881 ICD-10-PCS codes compared to 78,705 codes in 2018.
A few of the code changes are discussed here. For the complete list and how these codes are used and applied is covered in more detailed training on ICD-10-PCS Updates.

  • Additional approach value options in some tables
  • Additional qualifiers for body parts in bypass procedures
  • Qualifier for drug-coated balloon with Device value (D) for dilation procedures
  • New table (093K) Control of nasal mucosa and soft tissue bleeding
  • New table (0FD) for Extraction in the Hepatobiliary System and Pancreas
  • Delete Device option No Device (Z) from joint fusion tables
  • Changed qualifiers for C-Section
  • Add Transplantation of uterus
  • Added new qualifiers for ECMO

Guidelines

There were several guideline changes made to the 2019 ICD-10-PCS Official Guidelines for Coding and Reporting. An addition was made to A10 “And” guideline and B6.1a Device guideline. If a device that is intended to remain after the completion of a procedure is removed and reinserted (such as inadequate size) both the insertion and removal should be coded.

A new guideline, Transfer procedures using multiple tissue layers was added.

B3.17
The root operation Transfer contains qualifiers that can be used to specify when a transfer flap is composed of more than one tissue layer, such as a musculocutaneous flap. For procedures involving transfer of multiple tissue layers including skin, subcutaneous tissue, fascia or muscle, the procedure is coded to the body part value that describes the deepest tissue layer in the flap, and the qualifier can be used to describe the other tissue layer(s) in the transfer flap.
Example: A musculocutaneous flap transfer is coded to the appropriate body part value in the body system Muscles, and the qualifier is used to describe the additional tissue layer(s) in the transfer flap.

Impact of FY 2019 Changes

The additions of new approaches, sites and tables will provide advantages to all involved in the coding process. It is time-consuming and frustrating when trying to assign a code and there is no option, such as a missing table. Along with the advantages of new codes comes the challenges for all Healthcare entities. All coding professionals must keep current on all these coding and guideline changes. When assigning ICD-10-PCS codes, it is important to understand not only the new code, but information on new procedures/techniques. YES HIM Consulting and associates consider this type of information is critical to the coding process for ICD-10-PCS. Ongoing education will not only assist professionals in understanding the new procedure, how and when it is used, but how to correctly apply the new guidelines and assign the new codes.

Ann Zeisset

Ann Zeisset, RHIT, CCS, CCS-P Contract Educator Ann has over 30 years’ experience in HIM and coding, and is a nationally-recognized ICD-10-CM/PCS speaker, author, and educator. Ann is a speaker and author on coding related topics, including CPT, ICD-10-CM, ICD-10-PCS, and General Equivalence Mappings (GEMs). Ann is an AHIMA-approved ICD-10-CM/PCS trainer.
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