9/13/16

ICD-10-PCS GUIDELINE/
CODE CHANGES

2016 TO 2017

75,789 TOTAL PCS CODES

•  Medical, Surgical, Administration, Measurement

and Monitoring, Extracorporeal Therapies , and New
Technology all have changes

•  As expected

•  Guideline changes too

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THE SPECIFICS

•  3651 New Codes

•  487 Revised codes

•  2 Root operations revisited—Control and Creation

•  1 new Root Operation— Perfusion--Now we have

32!!

FOCUS ON GUIDELINES FIRST

•  B2.1a through B4.4

B2.1a—Change was a “should” to a “can” for general
anatomical regions when a procedure is performed on an
anatomical region rather than a body part; The
procedure codes in the general anatomical regions body
systems CAN be used. . . .
•  Chest tube drainage of pleural cavity codes to Drainage in
general anatomical regions body system and Suture repair of
abdominal wall is coded to Repair, general anatomical regions

•  B3.2 New examples of multiple procedures---Extraction

of multiple toenails are coded separately and Excision of
lesion in the ascending colon and transverse colon, also
separately.

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GUIDELINES

•  B3.4a Example Clarified

•  FNA Bx of FLUID IN THE lung is coded to root

operation Drainage with the Qualifier of
Diagnostic.
•  Bx of bone marrow is coded to the root
operation Extraction , also Diagnostic
•  Lymph node sampling for Bx is coded to the
root operation Excision, also Diagnostic

PCS CODING GUIDELINE CHANGES

•  B3.6b Change in language from coronary sites to

coronary arteries

•  B3.6c If multiple coronary arteries are bypassed

(eliminated the word “sites”)

•  B3.7 Change in definition of Control to include

“Stopping or attempting to stop, post procedural or
other acute bleeding.”

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GUIDELINE CHANGES

•  B3.9 If an autograft is obtained from a different

procedure site. . . . . . .separate procedure is coded
Used to say different body part

B4.2 Branches of body parts

New Example: Occlusion of the bronchial artery is coded to
the Upper Artery in the body system Upper Arteries, and NOT
to the body part value Thoracic Aorta, Descending, in Heart
and Great Vessels. Why?
In CV, if a general body part is available in the correct root
operation table, and coding to a proximal branch goes to
another body system, don’t go there!

CORONARY ARTERIES

•  B4.4 Coronary arteries are classified by number of

arteries treated ---Used to say number of sites
treated and not by name or number of arteries.
•  Dilation of Coronary Arteries, Two Arteries, w/
Intraluminal Device
•  Dilation of Coronary Artery, One Artery with
Intraluminal Device and Dilation of Coronary Artery,
One Artery with no device. Wording changes!

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CORONARY ARTERIES

•  One procedure code specifying multiple arteries is

used when the same procedure is performed,
including same device and qualifier values
•  Separate codes are used if multiple sites in the
coronary arteries
•  Examples: Angioplasty 2 distinct arteries in the LAD
coronary artery, w 2 stents: Dilation of Coronary
Arteries, 2 Arteries, w/ Intraluminal device
•  Angioplasty of 2 distinct arteries in the LAD, one with
stent and one without, coded separately

EXAMPLE OF NEW LANGUAGE, SAME

CODE
•  Last Year •  This Year
•  0211093 •  0211093
•  Bypass, Coronary •  Bypass Coronary
Artery, Two Sites Artery, Two Arteries
from Coronary from Coronary
Artery w/ Artery with
Autologous Venous Autologous Venous
Tissue, Open Tissue, Open
Approach Approach

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NEW DEFINITION OF CONTROL

•  Control is now defined as , “Stopping, or attempting

to stop, post procedural or other acute bleeding.”

•  Guideline B3.7 has same language—go to one of 7

others first instead of Control.
•  Example is the same—Resection of spleen to stop
bleeding is coded to Resection instead of Control

•  Coders should be consistent

CREATION

•  Definition: Putting in or on biological or synthetic

material to form a new body part that, to the extent
possible, replicates the anatomic structure or
function of an absent body part

•  Explanation: Yes, gender reassignment, but also

now corrective procedures in individuals with
congenital anomalies
•  Example: Creation of R and L atrioventricular valve
from common atrioventricular valve

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PERFUSION

•  Used in Sec 6 Extracorporeal Therapies

•  Example: Extracorporeal treatment by diffusion of

therapeutic fluid

NEW TECHNOLOGY SECTION X

•  Root Operations
•  Assistance, Fusion, Insertion, Removal, Replacement, Reposition,
Revision

Approaches include via natural or artificial opening; or

Via Natural or Artificial Opening Endoscopic

Assistance is taking over a portion of a physiological function by

extracorporeal means

Example is skin substitute, Porcine liver—wound matrix product

from porcine liver. Used to management wounds, diabetic foot,
venous and pressure ulcers, surgical and traumatic wounds.

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INDEX ADDITIONS: BODY PARTS

•  Thoracic Aorta, Ascending/ Arch

•  Thoracic Aorta, Descending
•  Base of tongue-see Pharynx
•  Bronchus Intermedius: See Main Bronchus, Right
•  Pulmonary Artery
•  Pulmonary Trunk
•  Intermediate Bronchus-see Main Bronchus, Right
•  Internal Carotid Artery, intracranial portion—Use
Intracranial artery

INDEX CORRECTIONS

•  Conization , cervix—See Excision, Cervix (not uterus)

•  Levator ani muscle—See Perineum Muscle

•  Ophthalmic Artery----Use Intracranial Artery

•  Ossicular Chain------ Deleted

•  Subcostal artery---Use Upper Artery (not thoracic)

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CORRECTED AND NEW TABLES

•  Lots of them

•  Too many to list

•  Examples
•  024 Heart and Great Vessels, Creation
•  0X3 Anatomical regions, Upper Extremities, Control
•  6AB Physiological Systems, Perfusion

CARDIOVASCULAR CHANGES

•  Changed Coronary Artery Site/Sites to Coronary

Arteries
•  Changed Thoracic Aorta to Thoracic Aorta,
Ascending/Arch and Thoracic Aorta, Descending
•  Added Pulmonary Vein, L and R and Confluence
•  Added Device: Intracardiac Pacemaker,
Zooplastic Tissue
•  Added Device detail to specific the number of
stents used when treating coronary arteries

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MORE CARDIOVASCULAR

•  In Bypass, new rows for Pulmonary Trunk, Pulmonary

Artery, L and R and for Thoracic Aorta, Descending
and Ascending/Arch
•  New table for Creation 024
•  Added rows for various valves in Repair and
Supplement
•  At qualifier, added bifurcation if not already there
•  New device, Intracardiac pacemaker, directly
implanted in R ventricle, small, no leads, fully self
contained. Read up on it!

FACE TRANSPLANT

•  First Academy question!

•  Now reality!
•  0WY Anatomical Regions, General, Transplantation
•  Body Part 2 Face
•  Approach Open
•  Device No device
•  Qualifier 0 Allogeneic 1 Syngeneic

•  0WY2020 or 0WY2021

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KEEP LEARNING

•  Lots to learn

•  Google constantly

•  Have fun learning!

•  The best predictor of future behavior is past

behavior
•  Thank you for participating!

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