November 14, 2011

ICD-10-PCS FY2012 Code Changes Published

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Hospital providers may now view and download the fiscal year 2012 changes to the ICD-10-PCS codes at the website of the Centers for Medicare & Medicaid Services. A review of these changes shows that the number of codes for has decreased by 163—from 72,081 procedure codes in FY2011 to 71,918 for FY2012. Here’s the breakdown by type of change:

 

  • 1,182 new codes
  • 381 revised codes
  • 1,345 deleted codes

CMS added ICD-10-PCS codes to correspond with the new ICD-9-CM procedure codes for FY2012, which take effect with discharge dates on and after October 1, 2011.  The agency also deleted procedure codes to alight with ICD-9-CM procedure code changes or to enhance consistency in ICD-10-PCS.

Public Input Considered

In response to input from the public, CMS added, deleted or revised codes, starting with the addition of several new qualifiers.

New Qualifier

Reason for Addition

Section Affected

Body Part

Vertical

To specify a vertical sleeve gastrectomy

Medical and Surgical

Stomach

Left atrial appendage

To specify procedures performed on the left atrial appendage

Medical and Surgical

Left atrium

Anti-infective envelope

To specify placing an antimicrobial envelope around the device (e.g. pacemaker generator) inserted into the subcutaneous tissue

Administration Section, Operation of Introduction

 

 

In addition, CMS revised device values, as needed, to adhere to the new device-maintenance standard. It also added body part values (treatment site) of respiratory, breast, and prostate for the laser interstitial thermal therapy (LITT) procedure for consistency—an addition that relates to the body parts specified in the “include” notes and index entries.

Two New Device-Classification Maintenance Standards

Based on industry feedback and internal review, CMS developed the two new maintenance standards below to preserve the usability and maintainability of PCS.

Device information is contained only in the device character. As explained by CMS, device information should not be split between the characters of the device and the qualifier. The qualifier should be reserved for the vital detail of the specific procedure performed; this cannot be captured using any of the other existing values.

If the seventh character qualifier is used to further specify a sixth character device value, then subsequent requests for additional specificity cannot be accommodated without adding information to the value that is unrelated to the device.  This makes the system difficult for coding professionals and subsequent users of the data and also inaccurate as a classification.

 


 

 

For example, CMS received a request to add further detail to hip-, knee-, and ankle-replacement procedures.  After internal review, it proposed a revision that would place all of the device detail in the device character. The requested detail would be added in the qualifier to specify the method used to affix the prosthetic joint.  CMS expanded the device values of a synthetic substitute to include the previous qualifiers such as metal on polyethylene, metal on metal, ceramic on ceramic, and ceramic on polyethylene, and it removed the terms “cemented” and “uncemented” from the device values.  The qualifier now includes these terms and the type of synthetic substitute previously noted as a qualifier, which is now captured in the device value (e.g. synthetic substitute, metal on metal noted as device value and cemented noted as the qualifier).

ICD-10-PCS contains a PCS-to-PCS Device Aggregation Table between the root operations that use both general and specific devices and those that only use general devices (such as removal and revision). There should be a correlation of a specific device value used in the original root operation where the device was placed (bypass, dilation, insertion, occlusion, replacement, etc.) with the more general device value used in other root operations.  The device values are often the aggregate, general device of an entire family of specific device values, in root operations such as “removal and revision.”

Take, for example, the specific device of “synthetic substitute, ceramic on ceramic,” which is used for a replacement operation in the body system of lower joint. It also states the general device value of a synthetic substitute.  Each specific device is assigned to its aggregate general device in the Device Aggregation Table.  This additional reference table provides a tool for directing coding professionals and subsequent data users to root operations in the system where the selection of device values may not be as specific as those used in the original root operations.

New ICD-10-PCS Draft Device Key

The PCS index and the standalone ICD-10-PCS reference tables contain more than 300 new entries.    The table lists the device name (common or brand name) as well as the PCS device value.  To access the device table by name click on the Device Key link and to access the device value click on the Definitions link in the ICD-10-PCS, 2012 Tables and Index.

To access the new and updated ICD-10-PCS files for FY2012 reference the below website:

http://www.cms.gov/ICD10/11b15_2012_ICD10PCS.asp#TopOfPage

Read 2219 times Updated on March 14, 2016
Lynn Cleasby, RHIT, AHIMA-Approved ICD-10-CM/PCS Trainer

Lynn’s expertise includes inpatient HIM coding audits and coding staff training. She also performs CDIP analysis and CDIP staff and Physician training projects. She is also an AHIMA certified ICD-10 Trainer.