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Coding update: ICD-10-PCS Code 2022

The 2022 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2021 through September 30, 2022. There are 191 new codes, 62 revised titles and 107 deleted codes.

Below is the snapshot of the FY 2022 ICD-10-PCS code Update Summary:

FY 2022 – ICD-10 PCS Updates
2021 Total New Codes Revised Titles Deleted Codes 2022 Total
78,136 191 62 107 78,220
FY 2022 – Total ICD-10-PCS Codes by Section # PCS Codes
Medical and Surgical 67754
Obstetrics 304
Placement 861
Administration 1253
Measurement and Monitoring 422
Extracorporeal or Systemic Assistance and Performance 52
Extracorporeal or Systemic Therapies 46
Osteopathic 100
Other Procedures 78
Chiropractic 90
Imaging 2977
Nuclear Medicine 463
Radiation Therapy 2087
Physical Rehabilitation and Diagnostic Audiology 1380
Mental Health 30
Substance Abuse Treatment 59
New Technology 264
Total ICD-10-PCS Codes 78220

2022 Official ICD-10-PCS Coding Guidelines Changes:

The below guidelines were revised in response to public comment and internal review.

B3.7       Root Operation – Control vs. more specific root operations

The root operation Control is defined as, “Stopping, or attempting to stop, postprocedural or other acute bleeding.” Control is the root operation coded when the procedure performed to achieve hemostasis, beyond what would be considered integral to a procedure, utilizes techniques (e.g., cautery, application of substances or pressure, suturing or ligation or clipping of bleeding points at the site) that are not described by a more specific root operation definition, such as Bypass, Detachment, Excision, Extraction, Reposition, Replacement, or Resection. If a more specific root operation definition applies to the procedure performed, then the more specific root operation is coded instead of Control.

Examples:

Silver nitrate cautery to treat acute nasal bleeding is coded to the root operation Control.

Liquid embolization of the right internal iliac artery to treat acute hematoma by stopping blood flow is coded to the root operation Occlusion.

Suctioning of residual blood to achieve hemostasis during a transbronchial cryobiopsy is considered integral to the cryobiopsy procedure and is not coded separately.

B4.1c     Body Part – General Guidelines

If a procedure is performed on a continuous section of a tubular body part, code the body part value corresponding to the anatomically most proximal (closest to the heart) portion of the tubular body part.

Example:

A procedure performed on a continuous section of artery from the femoral artery to the external iliac artery with the point of entry at the femoral artery is coded to the external iliac body part. A procedure performed on a continuous section of artery from the femoral artery to the external iliac artery with the point of entry at the external iliac artery is also coded to the external iliac artery body part.

B4.8       Body Part – Upper and lower intestinal tract

In the Gastrointestinal body system, the general body part values Upper Intestinal Tract and Lower Intestinal Tract are provided as an option for the root operations such as Change, Insertion, Inspection, Removal and Revision. Upper Intestinal Tract includes the portion of the gastrointestinal tract from the esophagus down to and including the duodenum, and Lower Intestinal Tract includes the portion of the gastrointestinal tract from the jejunum down to and including the rectum and anus.

Example:

In the root operation Change table, change of a device in the jejunum is coded using the body part Lower Intestinal Tract

New Technology Section – General guidelines

E1.a

Section X codes fully represent the specific procedure described in the code title, and do not require additional codes from other sections of ICD-10-PCS. When section X contains a code title which fully describes a specific new technology procedure, and it is the only procedure performed, only the section X code is reported for the procedure. There is no need to report an additional code in another section of ICD-10-PCS.

Example:

XW043A6 Introduction of Cefiderocol Anti-infective into Central Vein, Percutaneous Approach, New Technology Group 6, can be coded to indicate that Cefiderocol Anti-infective was administered via a central vein. A separate code from table 3E0 in the Administration section of ICD-10-PCS is not coded in addition to this code.

E1.b

When multiple procedures are performed, New Technology section X codes are coded following the multiple procedures guideline.

Examples:

Dual filter cerebral embolic filtration used during transcatheter aortic valve replacement (TAVR), X2A5312 Cerebral Embolic Filtration, Dual Filter in Innominate Artery and Left Common Carotid Artery, Percutaneous Approach, New Technology Group 2, is coded for the cerebral embolic filtration, along with an ICD-10-PCS code for the TAVR procedure.

An extracorporeal flow reversal circuit for embolic neuroprotection placed during a transcarotid arterial revascularization procedure, a code from table X2A, Assistance of the Cardiovascular System is coded for the use of the extracorporeal flow reversal circuit, along with an ICD-10-PCS code for the transcarotid arterial revascularization procedure.

ICD-10-PCS Character Definitions Updates

  • In Body parts “Dorsal root ganglion” was added to the cervical, thoracic, lumbar and spinal cord values.  Fibular sesamoid and Tibial sesamoid were added to the metatarsal body parts. Parapharyngeal space and Retropharyngeal space were added to the neck.
  • Several new devices were added to existing “Device Value Definitions” such as the Carmat total artificial heart (TAH), Alfapump® system, PERCEPT™ PC neurostimulator, InterStim™ II Therapy neurostimulator, InterStim™ Micro Therapy neurostimulator, and SynCardia (temporary) total artificial heart (TAH). The InterStim® Therapy neurostimulator was deleted.
  • Many new substances were added to existing substance values in the Administration section to allow the capture of named drugs and therapies. They include Gammaglobulin, Hyperimmune globulin, Immunoglobulin, polyclonal hyperimmune globulin, OTL-101, OTL-103, AVYCAZ® (ceftazidime-avibactam), Ceftazidime-avibactam, CRESEMBA® (isavuconazonium sulfate), Isavuconazole (Isavuconazonium sulfate), Blinatumomab, BLINCYTO® (blinatumomab sulfate), Idarucizumab, Pradaxa® (dabigatran) reversal agent, Praxbind® (idarucizumab), INTERCEPT Blood system for Plasma Pathogen Reduced Cryoprecipitated Fibrinogen Complex, INTERCEPT Fibrinogen Complex.
  • The New Technology Section X has NUMEROUS additions to Substances in which most of them are new substances used to treat COVID-19 and other conditions.

ICD-10 PCS Updates kindly download the files from the below reference link.

https://www.cms.gov/medicare/icd-10/2022-icd-10-pcs

https://www.cms.gov/files/document/2022-official-icd-10-pcs-coding-guidelines.pdf

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