2020 Foresight: The Next ICD-10-PCS Code Set Is Here

Mon, Jun 10, 2019 --

Uncategorized

ICD-10-PCS inpatient coding 2020

Code update season is a marathon, not a sprint. It’s June, and we’re already talking 2020 changes, so you’ve got to pace yourself. Below is a light warm-up to ease you into the coming ICD-10-PCS updates.

Remember: ICD-10-PCS, like ICD-10-CM, has its annual update October 1, the beginning of the fiscal year (FY). So the FY2020 code set, typically called just ICD-10-PCS 2020, is effective for dates of service Oct. 1, 2019, to Sept. 30, 2020.

Take In ICD-10-PCS 2019 by the Numbers

Knowing the numbers of codes may not help much with applying them, but the overview does offer a sense of perspective about how large the code set is and how many changes you’ll have to adjust to. The 2020 code set has fewer codes than the 2019 code set:

  • 2019 ICD-10-PCS codes total: 78,881
  • 2020 ICD-10-PCS codes total: 77,559
  • 2020 additions: 734
  • 2020 deletions: 2,056
  • 2020 revisions: 130 (2 revisions to both long and short titles, 128 revisions to short title only).

Tip: To find the complete code set, you can check the Downloads section at the bottom of the CMS 2020 ICD-10-PCS site. (If your TCI SuperCoder package includes ICD-10-PCS, we’ll have the changes posted on the site under Upcoming Changes soon.)

Get Specific With ICD-10-PCS 2020 Examples

Because of the way ICD-10-PCS is constructed, the addition of a single character to an ICD-10-PCS table can mean that there are suddenly a lot of new codes. And if more than one character is added, the numbers can really explode.

For instance, the table for ICD-10-PCS 02U in the 2020 code set adds four new characters for the fourth character options:

  • 0 (Coronary Artery, One Artery)
  • 1 (Coronary Artery, Two Arteries)
  • 2 (Coronary Artery, Three Arteries)
  • 3 (Coronary Artery, Four or More Arteries).

From those four characters come 48 new codes because of the different fifth and sixth character options available (the seventh character is always Z for these codes). As an example, compare the codes below, which have the same first four characters, but different fifth and sixth characters:

  • 02U007Z (Supplement Coronary Artery, One Artery with Autologous Tissue Substitute, Open Approach)
  • 02U038Z (Supplement Coronary Artery, One Artery with Zooplastic Tissue, Percutaneous Approach).

Similarly, the deletion of the seventh character 6 (Bifurcation) from table 037 (Medical and Surgical, Upper Arteries, Dilation) will result in a long list of code deletions.

Scan Definition Changes to Grasp Code Meaning

This inpatient procedure code set has its own language, so pay attention to the ICD-10-PCS definitions addenda (titled 2020 Reference Addenda), which helps you understand which term definitions apply. (Click 2020 ICD-10-PCS Addendum in the Downloads section of the CMS 2020 ICD-10-PCS site linked above to find the definitions addenda, as well as those for index and tables.)

One definition update example is the addition of Dilation for Section X (New Technology), Character 3 (Operation).

The definition you should apply for Dilation in that code location is “Expanding an orifice or the lumen of a tubular body part.” ICD-10-PCS also adds this: “Explanation: The orifice can be a natural orifice or an artificially created orifice. Accomplished by stretching a tubular body part using intraluminal pressure or by cutting part of the orifice or wall of the tubular body part.”

ICD-10-PCS 2020 adds this definition for dilation here because the code set has added a new table for X27 (New Technology, Cardiovascular System, Dilation), where you’ll build codes like X27H385 (Dilation of Right Femoral Artery with Sustained Release Drug-eluting Intraluminal Device, Percutaneous Approach, New Technology Group 5).

What About You?

Do you use ICD-10-PCS? How do you prepare for the updates?

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.

,

Leave a Reply