The Centers for Medicare & Medicaid Services (CMS) has released the fiscal year (FY) 2023 updates to the ICD-10-PCS codes. ICD-10-PCS is a procedure classification system CMS developed for procedure codes that track various health interventions made by medical professionals.
The FY 2023 updates include 64 deleted codes, 331 new procedure codes, and no revisions. This brings the total of ICD-10-PCS codes to 78,496. The updates are effective beginning October 1, 2022.
The majority of the deleted codes comprise laser interstitial thermal therapy procedures, which CMS has moved from the Radiation Therapy PCS table to the Destruction (eradication of all or a portion of a body part) PCS tables and expanded.
Another large portion of the deletions occurs in the new technology section. CMS is deleting new technology codes including the following:
Below are highlights of some of the new codes categorized by PCS table:
Central Nervous System and Cranial Nerves: This section has 15 new codes, including destruction of the brain and spinal cord using laser interstitial thermal therapy and extraction of the cerebellum.
Heart and Great Valves: There are three new codes in this section that describe the replacement of the aortic valve with zooplastic tissue (graft from human to animal) using the rapid deployment technique.
Lower Arteries: The 18 new codes in the lower artery section describe the occlusion of the left or right prostatic arteries through various approaches.
Respiratory System: There are 27 new codes in the respiratory system section for destruction of specific parts of the lungs using laser interstitial thermal therapy.
Gastrointestinal System: CMS has added 79 codes to this section. The additions include destruction of the esophagus, esophagogastric junction, stomach, small intestine, duodenum, jejunum, ileum, ileocecal valve, large intestine, cecum, appendix, colon, rectum, and anus. Also included are codes describing the transfer of the small or large intestine to the bladder or ureters.
Hepatobiliary System and Pancreas: There are 39 new codes in this section to describe the destruction using laser interstitial thermal therapy of the liver, gallbladder, hepatic, cystic, and common bile ducts, as well as the ampulla, pancreatic ducts, and pancreas.
Endocrine System: There are 66 new codes in the endocrine system section to describe the destruction using laser interstitial thermal therapy of the pituitary gland, adrenal glands, carotid bodies, para-aortic body, coccygeal glomus, glomus jugulare, aortic body, paraganglion extremity, thyroid glands, and parathyroid glands.
Skin and Breast: Six new codes in this section cover the destruction of the breast using laser interstitial thermal therapy.
Head and Facial Bones: There are eight new codes in this section describing the removal or revision of an infusion device in the skull.
Male Reproductive System: Three new codes in this section describe the destruction of the prostate using laser interstitial thermal therapy.
General Anatomical Regions: Six new codes in this section describe the drainage of the neck, either with or without a drainage device.
Physiological Systems and Anatomical Regions: Four new codes in this section describe the introduction of monoclonal antibodies and other therapeutic substances into the veins and bones.
Physiological Systems: One addition to the physiological systems section describes assistance with cardiac supersaturated oxygenation.
Respiratory System: There is one new code in this section to describe the magnetic resonance imaging (MRI) of the lungs using the hyperpolarized xenon 129 (Xe-129).
The remaining 55 new codes are within the New Technology section. CMS created a large portion of the new codes to report the introduction or transfusion of various anti-infectives, antineoplastics, immunotherapies, and cell therapies. Several new codes describe joint procedures, such as insertion or fusion of joints using internal fixation or spinal motion preservation devices and replacement of knee joints using synthetic substitutes. Two additional new codes cover the supplementation of spine bursa and ligament with a posterior vertebral tether.
Another group of additions to the new technology section is for the destruction of the liver tissue using ultrasound-guided cavitation. CMS created several more additions regarding measurement that include measurement of the following:
Other additions include the insertion of neurostimulator leads (sometimes paired with a stimulation system) into the nerves of the brain, computer-assisted transcranial magnetic stimulation of the prefrontal cortex, and intermittent coronary sinus occlusion.
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