A Taste of the 2019 ICD-10-PCS Changes

Coming soon to a code book near you! The 2019 ICD-10-CM and PCS updates take effect on October 1, 2018! The year has sped by and now it is time be sure you are prepared for the 2019 ICD-10 code updates!

PCS has 392 NEW codes however there were also 216 codes that were deleted so there is actually only an increase in the total number of PCS codes by 176! Does that make it sound better? These PCS code revisions/additions/deletions/new are the result of added, revised or deleted body parts, qualifiers, devices and root operations, mostly in the Medical and Surgical Section, adding needed specificity to the procedures.

So briefly, let’s take a look at just a few of the PCS changes for 2019:

A new guideline has been added to the Root Operations-B3.17 Transfer procedures using multiple tissue layers. This new guideline was added to clarify coding of a transfer flap when there is more than one tissue layer involved.

Also in the Root Operation Guidelines there is one repeat customer with another revision of Guideline B3.7 to further clarify when to use the root operation Control.

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There is also one update to Device guideline B6.1a providing further coding direction as follows “If a device that is intended to remain after the procedure is completed requires removal before the end of the operative episode in which it was inserted (for example, the device size is inadequate or a complication occurs), both the insertion and removal of the device should be coded.”

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There are 4 new PCS Tables for 2019:

• New PCS Table 093 Control Bleeding Ear, Nose, Sinus. This new table provides more specific coding for one of the most common hemorrhages, Nasal site bleeding, by adding root operation Control to the Ear, Nose, Sinus Body System.
• New PCS Table 0FD Extraction Hepatobiliary system and Pancreas. Root operation Extraction was added to capture additional detail for a biopsy of hepatobiliary & pancreas sites including the use of percutaneous fine needle aspiration to remove tissue and brush biopsies.
• New PCS Table 0VX added root operation Transfer to the Male Reproductive System to capture Male reproductive system reconstructive urology procedures including repair of hypospadias, genital trauma, skin defects and urethral strictures.
• New PCS Table XV5 in New Technology-Destruction Male Reproductive system using Aquablation. Robotic Waterjet Aquablation is a surgical procedure designed to replicate the efficacy of TURP or prostate enucleation using waterjet ablation therapy.

This is just a small taste of the many 2019 PCS updates that HIM professionals and CDI alike will be using starting October 1, 2018. In order to remain current in your profession and stay ahead of the game go to the following websites for complete official information on the ICD-10 CM and PCS updates for FY 2019 to be used for discharges occurring from October 1, 2018 through September 30, 2019:

• https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-PCS.html
• https://www.cdc.gov/nchs/icd/icd10cm.htm

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