Coders will find 50 new codes in ICD-10-PCS for 2016, according to the summary of changes posted by CMS. CMS also introduced a new section for ICD-10-PCS, X (new technology). In addition, guidelines B3.11b, B3.4a, B3.2b, and B4.1b were revised in response to public comment.
Fourteen of the new code appear in Section X, while the remaining new codes are in the Medical and Surgical section.
Section X provides a place for codes that uniquely identify procedures requested via the New Technology Application Process or that capture other new technologies not currently classified in ICD-10-PCS.
Guideline B3.11b, Inspection procedures, now includes the phrase “the body part furthest from the starting point of the inspection” to clarify the meaning of the most distal body part.
The phrase “The qualifier Diagnostic is used only for biopsies” was removed from Guideline B3.4a, Biopsy procedures.
CMS revised guideline B3.2b, Multiple procedures, to read:
The same root operation is repeated in multiple body parts, and those body parts are separate and distinct body parts classified to a single ICD-10-PCS body part value.
Example: Excision of the sartorius muscle and excision of the gracilis muscle are both included in the upper leg muscle body part value, and multiple procedures are coded.
CMS also expanded guideline B4.1b, which defines the prefix peri-. The guideline now states:
If the prefix “peri” is combined with a body part to identify the site of the procedure, and the site of the procedure is not further specified, then the procedure is coded to the body part named. This guideline applies only when a more specific body part value is not available.
Examples: A procedure site identified as perirenal is coded to the kidney body part when the site of the procedure is not further specified. A procedure site described in the documentation as peri-urethral, and the documentation also indicates that it is the vulvar tissue and not the urethral tissue that is the site of the procedure, then the procedure is coded to the vulva body part.
CMS posted the guidelines and ICD-10-CM code files with no changes for 2016.
