Updated on: June 11, 2020

Final FY21 ICD-10-PCS Codes Are Here

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Original story posted on: June 8, 2020

The FY21 ICD-10-CM codes will be finalized this month.

The Centers for Medicare and Medicaid Services (CMS) released the final FY21 ICD-10-PCS codes on May 28, 2020 which was earlier than expected.  The table below will show the changes between Final FY20, Proposed FY21, and Final FY21:

Section

FY20

Proposed FY21

Final FY21

Change FY20 – FY21

Medical & Surgical

67,257

67,380

67,655

398

Obstetrics

302

302

304

2

Placement

861

861

861

0

Administration

1,332

1,332

1,336

4

Measurement & Monitoring

418

419

421

3

Extracorporeal/Systemic Assistance & Performance

48

49

51

3

Extracorporeal/Systemic Therapies

46

46

46

0

Osteopathic

100

100

100

0

Other Procedures

77

78

78

1

Chiropractic

90

90

90

0

Imaging

2,941

2,969

2,973

32

Nuclear Medicine

463

463

463

0

Radiation Therapy

2,019

2,083

2,087

68

Physical Rehabilitation & Diagnostic Audiology

1,380

1,380

1,380

0

Mental Health

30

30

30

0

Substance Abuse Treatment

59

59

59

0

New Technology

136

142

169

33

Totals

77,559

 

78,103

544

This table will assist you in determining where to focus education and facility guideline updates.  In the Medical and Surgical Section, the root operation, Fragmentation, was added to several systems with percutaneous approach and ultrasonic qualifier.The device, Radioactive Element, was added to Central and Peripheral Nervous Systems; Ear, Nose, and Throat; Mouth and Throat; Gastrointestinal; Hepatobiliary System and Pancreas; Endocrine; Urinary; Female Reproductive; and Male Reproductive systems. A contractility modulation device was added to the Subcutaneous and Connective Tissue section.   The external fixation device was added to the 0QP Table.   An internal fixation device with sustained compression was added to Fusion for Lower Joints and Upper Joints. The root operation, Transplantation, was added to the Male Reproductive System.



In the Imaging Section, a fluorescing agent was added to contrast and bacterial autofluorescence was added to Qualifier options to some tables.  Radiation Therapy added isotope of Cesium 131.    The New Technology Section added new devices and new substances such as the following:

  • Brexanolone
  • Nerinitide
  • Durvalumab (Anti-neoplastic)
  • Lefamulin Anti-infective
  • Synthetic Substitute Mechanically Expandable
  • Cerebral Embolic Filtration, Extracorporeal Flow Reversal Circuit
  • Mineral-based Topical Hemostatic Agent
  • Eladocagene exaparvovec
  • Brexucabtagene Autoleucel Immunotherapy
  • Lisocabtagene Maraleucel Immunotherapy
  • Infection, Positive Blood Culture Fluorescence Hybridization for Organism Identification, Concentration, and Susceptibility
  • Infection, Lower Respiratory Fluid Nucleic Acid-base Microbial Detection

The New Technology additions give us a glimpse into possible New Technology Add-On Payments for FY21.

It is important to review these updates and determine if there are any changes in coding processes as well as identifying documentation in the electronic medical record which is applicable to the new procedures. It is also important to update your facility guidelines if any changes are made in the coding process.   Keep a version for FY20 so the applicable guidelines can be matched to the dates of service during a coding review or regulatory audit.

The FY21 ICD-10-CM codes will be finalized this month. The Final Rule for FY21 will be expected by August 7, 2020. More changes are on the way.

Programming Note: Laurie Johnson is a permanent panelist on Talk Ten Tuesdays. Listen to her live coding report every Tuesday, 10-10:30 a.m. EST.

Resources:

FY21 ICD-10-PCS: https://www.cms.gov/medicare/icd-10/2021-icd-10-pcs

FY21 ICD-10-PCS Official Coding and Reporting Guidelines: https://www.cms.gov/files/document/2021-official-icd-10-pcs-coding-guidelines.pdf

Laurie M. Johnson, MS, RHIA, FAHIMA AHIMA Approved ICD-10-CM/PCS Trainer

Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an American Health Information Management Association (AHIMA) approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.

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