The Centers for Medicare and Medicaid Services (CMS) recently released updates to the ICD-10-PCS coding guidelines for fiscal year 2022. These updates are important for coders to understand, as they provide guidance on how to properly assign codes for inpatient procedures. In this guide, we will discuss the key changes for ICD-10-PCS guideline updates for FY2022.
- Root Operation Extraction: The guidelines for the root operation “Extraction” have been revised to clarify that when a procedure involves removal of a device that is an integral part of a body system, the device is considered to be part of the body part being extracted. For example, if a pacemaker lead is removed, the body part value would be the heart, not the pacemaker lead.
- Medical and Surgical Approaches: The guidelines for the “Medical and Surgical” approach have been revised to clarify that if the objective of the procedure is to obtain a biopsy or specimen, the biopsy or specimen value should be coded as a separate procedure, in addition to the procedure performed to obtain the specimen.
- Root Operation Drainage: The guidelines for the root operation “Drainage” have been revised to clarify that when a drainage procedure involves the use of a device to maintain patency, the device is considered to be part of the procedure and should be coded as a separate device value.
- Root Operation Destruction: The guidelines for the root operation “Destruction” have been revised to clarify that destruction of a lesion that has been previously biopsied should be coded as a separate procedure, in addition to the procedure performed to destroy the lesion.
- Root Operation Bypass: The guidelines for the root operation “Bypass” have been revised to clarify that when a bypass procedure involves the use of a device to maintain patency, the device is considered to be part of the procedure and should be coded as a separate device value.
- Body System: The guidelines for the “Body System” value have been revised to clarify that when a procedure involves multiple body systems, the primary body system should be coded first, followed by the secondary body system(s).
- Substance Infusion: The guidelines for substance infusion have been revised to clarify that when a substance infusion is stopped or restarted, the time should be documented in the medical record and coded accordingly.
- Medical and Surgical, Obstetrics, and Radiation Therapy Approaches: The guidelines for the “Medical and Surgical,” “Obstetrics,” and “Radiation Therapy” approaches have been revised to clarify that when a procedure is performed through an orifice, the orifice value should be coded as a qualifier.
- Body Part and Body Part Approach: The guidelines for the “Body Part” and “Body Part Approach” values have been revised to clarify that if the approach involves multiple body parts, the primary body part should be coded first, followed by the secondary body part(s).
- Device Values: The guidelines for device values have been revised to clarify that when a device is used to maintain patency, the device value should be coded as “Continuous.”
Conclusion:
The updates to the ICD-10-PCS coding guidelines for FY2022 provide important guidance for coders to ensure accurate and consistent coding of inpatient procedures. It is important for coders to stay up-to-date with the latest changes and updates to the guidelines to ensure compliance and proper reimbursement. By understanding the key changes to the guidelines, coders can ensure that they are assigning codes correctly and accurately reflecting the procedures performed.