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CMS Releases FY 2021 ICD-10-PCS Code Set and Official Guidelines

Analysis  |  By Revenue Cycle Advisor  
   June 08, 2020

The agency also updated the 2021 ICD-10-PCS Official Guidelines for Coding and Reporting to include two new guidelines.

A version of this article was first published June 8, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

CMS recently released the fiscal year (FY) 2021 ICD-10-PCS code set, which includes 544 new codes for Fragmentations of the veins and arteries, Drainages of the pelvic cavity, and Imaging of various organs. It also released the FY 2021 ICD-10-PCS Official Guidelines for Coding and Reporting.

The new ICD-10-PCS code set take effect with discharges occurring from October 1, 2020, through September 30, 2021. This update increased the total number of ICD-10-PCS codes from 77,559 to 78,103.

The update includes new codes to tables 02F-06F, with the addition of the root operation Fragmentation to the heart and great vessels. These additions include ICD-10-PCS codes such as:

  • 03F83Z, Fragmentation of left brachial artery, percutaneous approach, ultrasonic
  • 04FM3Z0, Fragmentation of right popliteal artery, percutaneous approach, ultrasonic
  • 05F53Z0, Fragmentation of right subclavian vein, percutaneous approach, ultrasonic

CMS also added new ICD-10-PCS Drainage and Imaging codes. These include codes such as:

  • 0W9J70Z, Drainage of pelvic cavity with drainage device, via natural or artificial opening approach
  • 0W9J7ZX, Drainage of pelvic cavity, via natural or artificial opening approach, diagnostic
  • BF532ZZ, other Imaging of gallbladder and bile ducts using fluorescing agent                         
  • BF55200, other Imaging of liver using fluorescing agent, indocyanine green dye, intraoperative

The agency also updated the 2021 ICD-10-PCS Official Guidelines for Coding and Reporting to include two new guidelines: B3.18 and B5.2b.

According to new guideline B3.18, if an Excision or Resection of a body part is followed by a Replacement procedure, code both procedures to identify each distinct objective. The only exception to this, according to the guideline update, is when the Excision or Resection is considered integral and preparatory for the replacement procedure.

New guideline B5.2b states that procedures performed using the percutaneous endoscopic approach, with an incision or extension of an incision to assist in the Removal of all or a portion of a body part or to anastomose a tubular body part to complete the procedure, are coded to the approach value percutaneous endoscopic.

Coders should look to the official guidelines for additional information on when and how to apply these changes.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.

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