Take this quiz to identify where you need to focus your learning.
Think you have nailed down ICD-10-PCS code changes effective Oct. 1, 2018? Have you studied the ICD-10-PCS coding guidelines while familiarizing yourself with the 2019 code changes?
For several months now, you’ve been reporting 2019 PCS codes, and your success rate probably grows with each claim. Let’s test your knowledge of 2019 ICD-10-PCS codes, guidelines, tables, and device characters to ensure your coding continues to stay on track throughout the rest of the year.
Question 1: How many ICD-10-PCS code changes went into effect on Oct. 1, 2018?
Answer: There aren’t many ICD-10-PCS code changes effective Oct. 1, 2018. In all, you’ll find 392 new and eight revised codes in your 2019 ICD-10-PCS code book. You’ll also no longer notice that 216 codes were deleted from the code set.
Question 2: A new guideline was added to the Root Operations—B3.17 Transfer procedures using multiple tissue layers. Why was this new guideline introduced?
Answer: The new guideline was introduced to clarify coding of a transfer flap when there is more than one tissue layer involved.
For procedures involving transfer of multiple tissue layers (including skin, subcutaneous tissue, fascia or muscle), the procedure is reported to the body value that describes the deepest tissue layer in the flap, and the qualifier can be used to describe the other tissue layer or layers in the transfer flap.
Question 3: The guideline A10 has been revised. What is the change that you need to know?
Answer: The guideline A10 has been revised to explain that “and” means “and/or,” excluding when the word “and” is found in a qualifier (for instance the qualifier option for a muscle flap transfer from table 0KX during a mastectomy).
Question 4: The ICD-10-PCS guideline B3.7 has also been revised. What’s different in the 2019 code set?
Answer: The guideline B3.7 has been revised to strike off the word ‘initially’ to indicate the definitive procedure can be used at any time to stop the bleeding. This clarifies the previous mix-up on whether a control method must be used first before a definitive procedure can be reported.
Question 5: You’ll find new control codes related to nasal tissue in 2019 ICD-10-PCS. What are they?
Answer: The 2019 ICD-10-PCS code set has added new control codes related to nasal tissue. The new codes are: 093K7ZZ and 093K8ZZ. Note that the second code is endoscopic.
Question 6: How many new PCS Tables were added for 2019? And what are they?
Answer: For FY 2019, four new ICD-10-PCS Tables were added, including Table 093, Table 0FD, Table 0VX, and Table XV5.
Question 7: What do you need to know about the new Table 093 Control Bleeding Ear, Nose, Sinus?
Answer: The introduction of the new Table 093 is interesting to note. The Table is a new guideline to describe control of epistaxis from the nasal mucosa or soft tissue on the inside of the nose. This change is noteworthy as it represents a change in the guideline explanation of control as being reported only within an anatomical region of the body as against a specific body part.
Question 8: Are there new and revised device characters applicable to the knee joints established for FY 2019? What was the purpose?
Answer: Yes, there are new and revised characters pertaining to knee joints that have been established to help capture of additional detail for knee arthroplasty procedures. You can find these device characters under the root operation Replacement and Removal.
Question 9: Which 2019 ICD-10-PCS change will help in the proper classification of cesarean delivery procedures?
Answer: Effective Oct. 1, the qualifiers to describe the location of the incision during a cesarean delivery on Table 10D have been changed. This update will help in the correct classification of cesarean delivery procedures.
Question 10: How many new codes were added in the New Technology section in 2019 ICD-10-PCS?
Answer: Five new codes were added in the New Technology section, including one new Table (XV5) and a couple of new rows in the already existing Table XW0.
Note: Coders often make the mistake of overlooking new technology codes. It’s important that you and your team familiarize yourselves with the new technologies each year.
Bottom-Line: There’s no reason to feel overwhelmed when it comes to ICD-10-PCS coding. If you understand the ICD-10-PCS guidelines and refer to reliable ICD-10 coding resources, you’ll find accurate code assignment easier than you might have expected.