10 ICD-10-PCS Coding Questions to Test Your Skills

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.


Stay on Top of These ICD-10 Updates to Keep Your Reporting on Track in 2019

It’s that time of year again! As you prepare to flip the calendar to 2019, don’t forget to take some time to look back and review key 2018 ICD-10 updates, as these will factor significantly into your coding, compliance, and reimbursement for the coming year.


  • CMS Released Nearly 500 ICD-10-CM Code Changes for 2019

This summer, CMS released 470 + changes to the 2019 ICD-10-CM code set — including 279 new, 143 revised and 51 deleted ICD-10 codes. These ICD-10-CM codes will be used for discharges and patient encounters occurring from Oct. 1, 2018 through Sep. 30, 2019.

  • GEMs Files Take the Exit in 2019

The GEMs files have seen their day and will no longer be used. This is a blow for those medical coders who have been looking forward to checking the 2019 GEMs files. CMS announced the expiry of the GEMs file in the fiscal year 2019 IPP final rule, as it did not see the need for the files after the transition. Many organizations, however, will still offer the 2018 set for those looking to find the links between both ICD-9 and ICD-10 code sets.

  • 2019 ICD-10 Update & the MIPS Quality Measures Impacted

The CMS has identified four quality measures affected by the Oct. 1 ICD-10-CM updates. The measures affected are registry measures stewarded by the American Academy of Dermatology. Providers submitting performance data under the MIPS should limit data collection to the first nine months (from January 1 to October 1) of the performance period for these quality measures. Get more details here.

  • Q4 2018 Coding Clinic Addressed Infamous Excludes1 Dilemma for Good

Coding Excludes1 notes have been a controversial topic among hospitals and medical practices, largely due to the lack of definitive guidelines. For at least the last five years, Excludes1 notes have eluded the AHA Coding Clinic  – much to the disappointment of coders.  Finally, though, the Q4 2018 Coding Clinic delivers clarity on diagnoses paired by an Excludes1 note.

  • CDC Introduced New ICD-10 Codes to Stop Human Trafficking

Among other notable ICD-10 developments this year, 29 new T codes that address human trafficking were introduced. These codes, published by the CDC last June, went into effect on Oct. 1. The American Hospital Association (AHA) had asked the ICD-10-CM Coordination and Maintenance committee to create these T codes as part of its Hospitals Against Violence initiative with the aim of equipping providers with the ability to document clients at risk of sex and labor exploitation. The AHA is encouraging coders to identify signs of abuse in the documentation and to employ the new T codes to report such cases.

The Road Ahead

Are you on top of these ICD-10 updates? You may be wondering how all this change your reimbursement? As changes will continue through 2019 and beyond, you’ll need to keep an eye out for what’s new and adapt quickly.

Stay in the know and prepare your team for claim success by investing in reliable ICD-10 resources — such as ICD-10 coding books (with complete code set, official ICD-10 coding guidelines, and numerous bonus features), newsletters, charts, and more.

Buy 2019 ICD-10 Code Books Bundle – TCI


The 2019 ICD-10-CM and ICD-10-PCS code changes were released earlier than last year — but you cannot afford to postpone your preparations for Oct. 1. For ICD-10-CM, there are 279 new, 143 revised, and 51 deleted codes while for ICD-10-PCS, there are 392 additions, eight revisions, and 216 deletions.

Many of the 2019 ICD-10-CM codes focus on intricacies of disorders — from acute appendicitis and squamous cell carcinoma skin to ecstasy poisoning and fractures of the fingers. ICD-10-PCS introduces new codes for influenza vaccine, plazomicin anti-infective, and synthetic human angiotensin II along with hundreds of other inpatient procedure code updates.

Need help to fast track your learning of 2019 ICD-10-CM and ICD-10-PCS changes?

Zip through 2019 diagnostic and inpatient procedures code changes and get all the information you’ll need for accurate reporting with 2019 ICD-10 Books Bundle — packed with two essential ICD-10 coding books at a pocket-friendly price:

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