This page addresses follow-up questions and additional information pertinent to our webinar
Navigating New Technology and Administration.
The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: How can CAR T-cell therapies be both a pre-MDC and have an NTAP? Doesn’t the fact that they have their own MS-DRG allow for appropriate reimbursement?
A: Although there is a specific MS-DRG (018) for CAR T-cell therapies, which is based on pre-MDCs, there is not enough claims data to evaluate the costs of these drugs since they are new. As a result, some of the newer CAR T-cell therapies have new technology add-on payments. As more claims data becomes available, the relative weight for MS-DRG 018 will be recalibrated to reflect resource consumption.
Q: How is the PiCSO Impulse System, different from an intra-aortic balloon pump?
A: While both the PiCSO Impulse System an intra-aortic balloon pump (IABP) utilize a balloon that sequentially inflates and deflates and they both code to the root operation Assistance, they are different in their placement and intent. An IABP is placed in the aorta to inflate as the heart relaxes an deflate as it contracts to help the heart push more blood to the body. The PiCSO Impulse System is placed in the coronary sinus, which is the major cardiac vein that returns oxygen-depleted blood from the heart muscle to the right atrium. The intent of the PiCSO Impulse System is to remove oxygen-poor blood from the heart muscle more efficiently to assist in reperfusion of the heart. IABP is coded to the Extracorporeal Assistance and Performance section of ICD-10-PCS, while the PiCSO Impulse System is reported with a New Technology code.
Q: The Ellipsys percutaneous arteriovenous fistula procedure is reported using New Technology codes X2KB317 and X2KC317. Are these same codes used to report percutaneous AVF formation using the WavelinQ device?
A: No. The Ellipsys percutaneous arteriovenous fistula (pAVF) procedure uses thermal resistance energy to form the arteriovenous anastomosis and that is what makes the procedure unique. In the X2K table, the sixth character for “Thermal Resistance Energy” is specific to the Ellipsys. Use codes in table 031 (Upper Arteries) to report the WavelinQ procedure.
Q: When the SpineJack device is used to treat vertebral compression fractures, two devices are placed. Is this coded once or twice per level?
A: Assign a code from the XNU table once to report insertion of paired SpineJack devices at a single level. The sixth character for device indicates that this includes the paired device.
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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.