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.

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Buy 2019 ICD-10 Code Books Bundle – TCI

2019-icd-10-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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  • ICD-10-PCS Complete Code Set 2019 Get complete ICD-10-PCS code set, including 2019 code changes, official guidelines and conventions/additional conventions, full Index and Tables, an Approach Table with full definitions and examples, anatomical illustrations, and all the essentials you need to nail your inpatient procedures claims. You’ll also find reimbursement alerts along with several bonus features to assist your reporting.

Four Pillars of Successful Medical Practice  – The Coding Institute

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What is New 2019 ICD-10-CM Codes? – TCI

Pay Attention to These New 2019 ICD-10-CM Codes to Maximize Reimbursement Success

2019 ICD-10-CM Codes to Maximize Reimbursement Success - The Coding Institute

The newest changes to the ICD-10-CM code set will go into effect in just a few days – but if you’re still waiting for the arrival of your 2019 ICD-10 coding books to start your preparation, here’s an overview of some new codes you’re using for your specialty effective Oct. 1:

Cardiology: Welcome New Cerebral Infarction & Cerebrovascular Disease Codes

Cardiology practices will now have two new codes I63.81 and I63.89 to report cerebral infarction under category I63-.The 2019 code set also adds new subcategory I67.85- under Category I67-. And under the new sub category, you’ll find two additional cerebrovascular disease codes: I67.850 and I67.858.

Gastroenterology: Find New Reporting Options for Abscess, Gallbladder Disorders, and More 

The 2019 ICD-10-CM code set introduces several new abscess codes K61.31 (horseshoe abscess), K61.39 (other ischiorectal abscess) and K61.5 (supralevator abscess). These codes will provide clarity when gastroenterology surgeons perform more invasive procedures.

In addition, you’ll see new codes for gallbladder disorders K82.A, K82.A1, and K82.A2 along with two new, more specific codes for cholangitis K83.01 and K83.09 that replaces the catch-all code K83.0.

Ophthalmology: Pay Attention to New Codes in Eyelid Cancer Category & Blepharitis 

Of all the specialties, ophthalmology has the maximum number of new codes this year. You’ll find several new codes in the eyelid cancer category, many of which were actually proposed by the AAO last year but were not implemented. Among the most notable updates are new codes under the C43.1 category that provides site-specific codes to specify which eyelid is affected, such as: C43.111, C43.112, C43.121, and C43.122.

Additionally, there are also new codes affecting laterality and upper/lower eyelid: C4A.1, C44.10, C44.11, C44.12, and C44.19. You’ll also find more site-specific codes for eyelid lesions in the “Neoplasms” section of ICD-10, including D03.11, D22.11, and D23.12.

This year’s crop of new codes also includes several new diagnoses related to blepharitis H01.00A, H01.00B, H01.01A, H01.01B, H01.02A, and H01.02B and a completely new categoryC44.13 that includes seven new codes to describe the site or whether the location is unspecified.

Eye care coders will also be pleased to find an entire new subcategory for paralytic ectropion of eyelid (H02.15) with seven code options, and new codes for multiple lagophthalmos conditions.

Ob-Gyn: Explore New Series of Multiple Gestation Codes, Surgical Wound Infection 

Ob-gyn specialty is also majorly impacted, with a new series of multiple gestation codes that specify that the number of chorions and amnions equal the number of fetuses. New codes for triplet pregnancies include: O30.131, O30.132, O30.133, and O30.139 with similar codes for quadruplet pregnancy: O30.231, O30.232, O30.233, and O30.239.

The infection of obstetric surgical wound code O86.0 expands to include six new codes, including O86.00 and O86.01. In addition, you will also find a new maternal depression screening code Z13.32.

There are also a bunch of new gynecology diagnoses that ob-gyn coders will need to master — such as N35.92. Plus, five new abnormal urine finding codes to use in place of existing code R82.99 that expands to include R82.991, R82.992, R82.993, R82.994, and R82.998.

Orthopedics: Use New Codes for Myalgia, Muscular Dystrophy

Orthopedics is also majorly impacted, including some significant additions that address myalgia — M79.10, M79.11, M79.12, and M79.18. You can also expect to report one out of the four new, more specific codes from the G71 series for muscular dystrophy.

Pediatrics: Don’t Overlook New Codes for Newborn Affected by Maternal Use

Pediatrics is also one of the top impacted specialties, with over 50 new codes. You’ll look forward to new codes for ‘newborn affected by maternal use’ of various drugs as well as more specific codes for Zika virus and child sexual exploitation and forced labor.

Urology: Dig Into New Urethral Stricture Codes

Urology figures among the top 10 specialties impacted by this year’s code changes, with 30 new codes to adopt. You’ll have a dozen new codes that address urethral stricture, both male and female, by the site of the stricture (N35), including N35.81, N35.811, and N35.812. The 2019 ICD-10-CM code set will also add eight more “unspecified” options to your urethral stricture coding armory.

Additionally, you’ll spot eight new codes being added to focus on postprocedural urethral stricture and abnormal findings in urine, such as N35.016, N35.116, N99.116, and R82.991, just to mention a few.

Assign New Codes with Confidence

You’ve got numerous new codes —and umpteen revisions — to analyze properly to secure your diagnostic coding compliance—and maximize your reimbursement success. To report accurately, consider investing in updated medical code books that includes new/revised ICD-10-CM codes and their descriptors, practical advice and key features — including the official ICD-10 coding guidelines, tips for interpreting guidelines, and more.

Source: New ICD-10-CM Codes for 2019

2019 ICD-10-CM: Stay on Your Toes to Keep Your Radiology Claims on Track

As is the yearly expectation with radiology, 2019 ICD-10-CM changes for this specialty are vast and far-reaching — including code additions for testicles and other specified body structures and abnormal radiologic findings. Your practice can’t afford to overlook these, and other changes being made to radiology coding guidelines.

Take a look at some of the most applicable ICD-10-CM changes for radiology.

ICD-10-CM-Radiology

Scan New Abnormal Radiologic Imaging Codes

Be prepared to incorporate four new abnormal urological imaging codes on Oct. 1 — R93.811 (right testicle), R93.812 (left testicle), R93.813 (testicles, bilateral), and R93.819 (unspecified testicle). This set of codes may serve as a good alternative to a code such as N50.9.

Heed New Cerebrovascular-Specific Codes

Your radiology coding will be impacted by a set of new cerebrovascular-specific ICD-10-CM codes. You’ll report a new code for a small artery cerebral infarction (I63.81), and a specific code for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (I67.850). You’ll also find a new set of hereditary cerebrovascular diseases codes (I67.85-) and a new option to report other hereditary cerebrovascular disease (I67.858). The existing cerebral infarction code I63.8 will change to I63.89.

Look to New, Specific Acute Appendicitis with Peritonitis Codes 

Your radiology practice should also make a note of nearly 10 new and more specific appendicitis with peritonitis combination codes: K35.20, K35.21, K35.30, K35.31, K35.32, K35.33, K35.890, and K35.891. To appropriately report these codes for acute appendicitis, make sure your documentation mentions the presence of any abscess, perforation or gangrene.

Employ These New All-Important Gastroenterological Codes

Plus, don’t forget to add these gastroenterology codes to your coding list. You’ll have new codes for anorectal supralevator and horseshoe abscesses — K61.31 and K61.5 respectively — along with a new code to report primary sclerosing cholangitis — K83.01. You’ll also find a new code set — K82.A1 and K82.A2 — to report gangrene or perforation of the gallbladder in a patient with a cholecystitis diagnosis.

Check Out New Triplet, Quadruplet Code Sets

Also in queue are new codes to report triplet, quadruplet, and other multiple gestation pregnancies  that specify that the number of chorions and amnions equal the number of fetuses, such as O30.1 Triplet pregnancy — O30.13 (Triplet pregnancy, trichorionic/triamniotic), O30.131 (Triplet pregnancy, trichorionic/triamniotic, first trimester), O30.132 (Triplet pregnancy, trichorionic/triamniotic, second trimester), O30.133 (Triplet pregnancy, trichorionic/triamniotic, third trimester), O30.139 (Triplet pregnancy, trichorionic/triamniotic, unspecified trimester).

For in-depth details on the triplet, quadruplet code sets and to polish up your coding for the new, revised and deleted ICD-10-CM codes, tune in to Radiology Coding Alert or ICD-10 Coding Alert.

Understand what the 2019 ICD-10-CM changes mean for your radiology practice, find out what are the changes being made to radiology coding guidelines, and learn the exact coding conventions for a variety of other diagnoses.