2019 Updates on the Horizon: See What’s Coming for ICD-10-PCS

2019 inpatient ICD-10-PCS new codes

You may have noticed 2019 ICD-10-PCS changes already posted on your TCI SuperCoder Coding Tools page, if that’s your medical coding software. (2019 … whoa!) Let’s check out the trends in the new 2019 ICD-10-PCS codes for inpatient reporting.

The numbers: There are 392 new codes, eight revised titles, and 216 deleted codes, according to the ICD-10-PCS FY 2019 Update Summary posted by CMS. That’s a net gain, going from 78,705 codes in 2018 to a whopping 78,881 in the 2019 code set.

Reminder: You won’t use this 2019 code set until you’re reporting for dates of service on or after Oct. 1, 2018. Check the complete updated code set at that time in case there are changes to this preliminary release.

Bypass

For bypass (which PCS defines as “altering the route of passage of the contents of a tubular body part”), watch for new options related to these anatomic areas:

  • Spinal canal
  • Thoracic aorta, descending
  • Axillary artery
  • Common carotid artery
  • Femoral artery
  • Popliteal artery
  • Anterior tibial artery
  • Posterior tibial artery
  • Peroneal artery
  • Foot artery
  • Pleural cavity
  • Peritoneal cavity
  • Pelvic cavity.

Dilation

Dilation (“expanding an orifice or the lumen of a tubular body part”) will have some new coding options for these arteries and veins:

  • Internal mammary artery
  • Innominate artery
  • Innominate vein
  • Subclavian artery
  • Subclavian vein
  • Axillary artery
  • Axillary vein
  • Brachial artery
  • Brachial vein
  • Ulnar artery
  • Radial artery
  • Basilic vein
  • Cephalic vein.

Extirpation

Extirpation is an important word to add to your vocabulary. For PCS purposes, it means “taking or cutting out solid matter from a body part.” In the 2019 code set, you will have new extirpation coding options for these body parts:

  • Intracranial artery
  • Common carotid artery
  • Internal carotid artery
  • External carotid artery
  • Vertebral artery.

Control

Control, which is “stopping, or attempting to stop, postprocedural or other acute bleeding,” will have new codes related to nasal tissue. There are just two, so I’ll list them here. Note that the second one is endoscopic:

  • 093K7ZZ (Control Bleeding in Nasal Mucosa and Soft Tissue, Via Natural or Artificial Opening)
  • 093K8ZZ (Control Bleeding in Nasal Mucosa and Soft Tissue, Via Natural or Artificial Opening Endoscopic).

Destruction

The next group of additions relate to destruction, “physical eradication of all or a portion of a body part by the direct use of energy, force, or a destructive agent.” The body parts featuring in the updates are below:

  • Liver
  • Lobe of liver
  • Pancreas

There’s also a new technology code to watch for destruction:

  • XV508A4 (Destruction of Prostate using Robotic Waterjet Ablation, Via Natural or Artificial Opening Endoscopic, New Technology Group 4).

Extraction

Extraction, “pulling or stripping out or off all or a portion of a body part by the use of force,” has some expected new codes, too. Note these body parts involved in the new codes:

  • Liver
  • Lobe of liver
  • Gallbladder
  • Hepatic duct
  • Cystic duct
  • Bile duct
  • Ampulla of Vater
  • Pancreatic duct
  • Accessory pancreatic duct
  • Pancreas.

Removal

PCS coders know that removal is specific to “taking out or off a device from a body part.” Changes for removal procedures in the 2019 code set affect these body parts:

  • Hip joint
  • Knee joint.

Replacement

Replacement is “putting in or on biological synthetic material that physically takes the place and/or function of all or a portion of a bod part.” Like the removal codes, the new replacement codes also apply to:

  • Hip joint
  • Knee joint.

Transplantation

The uterus is the only body part that features in new transplantation codes for “putting in or on all or a portion of a living body part taken from another individual or animal to physically take the place and/or function of all or a portion of a similar body part.”

Transfer

PCS coders have to be sure not to confuse transplantation with transfer, “moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion of a body part.” The 2019 code set adds codes for transfer of the male prepuce, which is the foreskin.

Introduction

Introduction is a term that you should know, but your patients probably don’t think of, for “putting in or on a therapeutic, diagnostic, nutritional, physiological, or prophylactic substance except blood or blood products.” In 2019, there are new introduction codes for:

  • Influenza vaccine
  • Plazomicin anti-infective
  • Synthetic human angiotensin II.

Performance

Performance is “completely taking over a physiological function by extracorporeal means.” Extracorporeal means outside the body. All of the new performance codes apply to extracorporeal oxygenation, membrane (ECMO), specifically:

  • Central
  • Peripheral veno-arterial
  • Peripheral veno-venous.

What About You?

Do you use ICD-10-PCS for inpatient coding? What do you think of the changes? Don’t forget to check the updated 2019 Official Guidelines, too!

 

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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