New codes and guidelines become effective Oct. 1, 2023.

The Centers for Medicare & Medicaid Services (CMS) published the ICD-10-PCS codes and guidelines for the 2023 fiscal year on May 26, 2022. These inpatient procedure codes and guidelines will become effective Oct. 1, 2022.

There are 331 new procedure codes and 64 deleted codes. The guidelines have added B3.19 (Detachment procedures of the extremities) and revised B4.1c (Procedure on Tubular Body Parts) and B6.1a (General Coding of Device).

The new guideline B3.19 provides detailed instructions regarding the coding of complete and partial amputation of the extremities by including this table for the qualifiers:

The revision to guideline B4.1c is a further specification that when a vascular procedure is performed on a continuous section of artery or vein, the body part value for the anatomically most proximal (closest to the heart) should be used. For example, say the procedure is performed on a continuous section of artery from the femoral artery to the external iliac artery, with the point of entry at the femoral artery. In this case, the body part value should be the external iliac artery. If the point of entry was the external iliac artery, then the body part value that would be assigned is still the external iliac artery.

The update to B6.1a is a minor change that advises the coder on how to code the insertion and removal of a device when the intent is for the device to remain after the procedure, but the device needs to be removed prior to the end of the procedure due to inadequate size or a documented complication. In this situation, the coder would assign a code for insertion and removal of the device.

The new procedure codes cover the following topics:

  • Destruction by laser interstitial thermal therapy (note: the LITT codes in the Radiology Section have been deleted for this technique);
  • Extraction of cerebellum;
  • Replacement of aortic valve using rapid deployment technique (movement of the codes from New Technology Section to Medical and Surgical Section);
  • Occlusion of prostatic artery;
  • Transfer of small intestine;
  • Removal of infusion device from skull;
  • Drainage of neck;
  • Introduction of other therapeutic monoclonal antibody;
  • Introduction of other therapeutic substance into bones;
  • Assistance with cardiac oxygenation, supersaturated;
  • Fusion of sacroiliac joints with tulip connector;
  • Infusion or transfusion of various substances, New Technology Group 8; and
  • Measurement of coronary artery flow.

This article gives you a peek into the changes and updates for the 2023 ICD-10-PCS codes and guidelines. Please note that the new procedure codes in the New Technology Section can be identified in the qualifier as New Technology Group 8. There will be more information provided in the Inpatient Prospective Payment System (IPPS) webinar series in August 2022.

Programming Note: Listen to Laurie Johnson’s Coding Report every Tuesday on Talk Ten Tuesdays at 10 Eastern with Chuck Buck and Dr. Erica Remer.

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