New Codes for Improved Specificity in Inpatient Procedures
The ICD-10-PCS code set update for fiscal year (FY) 2025 introduces 371 new codes for hospital inpatient procedures. Additionally, 61 codes have been deleted, with no revisions to existing codes. These changes, effective October 1, 2024, aim to enhance the specificity and accuracy of reporting inpatient procedures. Here’s a detailed overview of the key updates.
Medical and Surgical Procedures
The majority of the new codes pertain to medical and surgical procedures, with notable changes including:
- 00503Z4: Destruction of Brain using Stereoelectroencephalographic Radiofrequency Ablation, Percutaneous Approach (previously coded 00503ZZ).
- 00K0XZ1: Map Brain using Connectomic Analysis, External Approach.
Additional updates include 20 new codes for hepatic or splenic artery bypasses and 40 new codes for dilation of various arteries with drug-eluting intraluminal devices. The most significant addition is the new root operation table 071, Bypass of Lymphatic and Hemic Systems.
Example Changes in Medical and Surgical Tables:
- Hepatic or Splenic Artery to Lower Artery Bypass: 20 new codes in the 041 table.
- Dilation of Arteries with Drug-Eluting Devices: 40 new codes in the 047 table, including specific codes for dilation of the right or left femoral, popliteal, anterior tibial, posterior tibial, and peroneal arteries.
New Technology
Innovations in medical technology have led to several new ICD-10-PCS codes for FY 2025. These codes reflect the incorporation of advanced procedures and devices into medical practice:
- X05133A: Destruction of Renal Sympathetic Nerve(s) using Radiofrequency Ablation, Percutaneous Approach, New Technology Group 10.
- X28F3VA: Division of Aortic Valve using Intraluminal Bioprosthetic Valve Leaflet Splitting Technology in Existing Valve, Percutaneous Approach, New Technology Group 10.
The XW0 table also sees new additions like XW0333A and XW0433A for the administration of bentracimab, alongside other introduction code changes.
Highlights from the ICD-10 Coordination and Maintenance Committee
The March 19, 2024, ICD-10 Coordination and Maintenance Committee (CMC) meeting highlighted several new codes. Here are some key points:
- X2VE3SA: Restriction of Descending Thoracic Aorta and Abdominal Aorta using Branched Intraluminal Device, Manufactured Integrated System, Four or More Arteries, Percutaneous Approach, New Technology Group 10. This code reports the insertion of a thoracoabdominal branch endoprosthesis using the GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE) device for treating thoracoabdominal and pararenal aortic aneurysms.
- XRGx0CA: Fusion of [body part] using Gyroid-Sheet Lattice Design Internal Fixation Device, Open Approach, New Technology Group 10. This code describes the use of Restore3d TIDAL™ fusion cages in tibiotalocalcaneal fusion or arthrodesis procedures.
- 8E023FZ: Fiber Optic 3D Guided Procedure of Circulatory System, Percutaneous Approach. This code is for procedures using the Philips LumiGuide fiber optic 3D guidance device for real-time 3D visualization during endovascular procedures.
Detailed Breakdown of New Codes
- Visualization and Analysis of Brain Networks in MRI: 00K0XZ1 for mapping the brain using connectomic analysis and visualization. This procedure utilizes the Quicktome device for processing diffusion-weighted MRI sequences into 3D maps, aiding in better assessment of the brain's structural layout.
- Lymphatic Bypass: Codes in the 071xxZx format for direct lymphatic system bypass to a vein or other lymphatic structures. These procedures are commonly performed on mastectomy patients and during radical prostatectomies to treat or prevent lymphedema.
- Extracorporeal Circulatory Filtration: 5A05A0L for intraoperative extracorporeal peripheral veno-venous filtration during a percutaneous thrombectomy. This procedure uses the AngioVac System for extracorporeal circulatory support and filtration.
- Quantitative Antimicrobial Susceptibility Testing: XXE5X4A for testing organisms from positive blood culture using small molecule sensor array technology, such as bioMerieux’s VITEK® REVEAL™ Rapid AST System.
- Transcatheter Tricuspid Valve Replacement: X2RJ3RA for replacement of the tricuspid valve with multi-plane flex technology bioprosthetic valve, using the Edwards EVOQUE system for treating severe tricuspid regurgitation.
These updates to the ICD-10-PCS code set for FY 2025 are designed to provide more precise reporting for a wide range of inpatient procedures. Staying informed about these changes ensures accurate documentation and compliance with the latest standards.
