It hardly seems possible that it’s been nearly 6 months since the October ICD-10 updates. And while April updates to ICD-10-PCS are hardly new, this year the code changes are no longer limited to new technologies. Compared to ICD-10-CM changes, the PCS code changes that will become effective on April 1, 2023, are nominal. Nevertheless, here’s what you need to know about what’s coming next month.
You can download the updated code tables and addenda from CMS’ website. There are no guideline changes for this biannual update. Even if you are using an encoder, it’s important to note these code changes so that you know which search terms to use on your coding journey.
Temporary Balloon Occlusion
Codes for temporary balloon occlusion of the aorta are not new, but a new approach value is being added to tables 02L and 04L for the body parts descending thoracic and abdominal aorta: Open (0). The result is two new codes:
|02LW0DJ||Occlusion, descending thoracic aorta, intraluminal device, temporary, open|
|04L00DJ||Occlusion, abdominal aorta, intraluminal device, temporary, open|
Temporary balloon occlusion is an alternative to cross-clamping the aorta. The balloon is placed in the aorta and inflated to stop blood flow.
Laser Interstitial Thermal Therapy (LITT)
In October, laser interstitial thermal therapy (LITT) was reclassified from the Radiation Therapy section to the Medical and Surgical section, reported with the root operation Destruction. While there was no Radiation Therapy code to report LITT of the vertebral column, CMS is now adding a new qualifier to the 0P5 and 0Q5 tables to report LITT performed on the cervical, thoracic, and lumbar vertebrae as well as the sacrum. This results in 12 new codes (four body part and three approach value options).
Intraosseous Blood Transfusion
An intraosseous blood transfusion is a method of delivering blood products directly into the bone marrow. This may be necessary in pediatric patients or emergent situations when obtaining IV access is difficult. Currently, there are no codes to report administration of blood products via an intraosseous infusion. On April 1, a new body part is being added to the 302 table for bone marrow to allow for reporting intraosseous blood transfusion.
REGEN-COV® Monoclonal Antibody Administration
REGEN-COV® is a combination of two monoclonal antibody (MAB) treatments, casirivimab and imdevimab, for the treatment and prevention of COVID-19. The drugs are mixed together and administered as a single injection or infusion into the subcutaneous tissues. ICD-10-PCS has existing codes for administration of this drug in the XW0 table when administered intravenously, but the subcutaneous tissue body part is a new addition as of April 1.
Sabizabulin is a drug indicated for patients with moderate to severe COVID-19 who are at high risk for acute respiratory distress syndrome (ARDS). This orally administered antiviral/anti-inflammatory therapeutic is being added as a new substance in the XW0 table. The result is three new codes.
Exagamglogene autotemcel, also known as exa-cel (formerly CTX 001), is an autologous gene-edited hematopoietic stem cell therapy for treatment of severe hemoglobinopathies, such as beta-thalassemia and sickle cell anemia. Two new codes are being added to the XW1 table to report administration of this substance.
Keep Up with Updates
Not sure how to keep up with all these updates? Have no fear, that’s why we’re here! Be sure to stay tuned to our monthly webinars and blog postings to keep abreast of the code changes!
Looking for additional information on this topic?
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Director of Coding Quality & Education
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.