With the 2018 fiscal year having just begun on October 1st, a host of new ICD-10-PCS codes have entered standard usage. This includes additions and changes to the field of device insertion, beginning with the new PCS qualifier of J-Intraoperative. This latest qualifier was appended to body part A-Heart, which is contained within table 02H (Insertion, Heart and Great Vessels). Additionally, R was updated from External Heart Assist System to Short-term External Heart Assist System.
According to the Centers for Medicare and Medicaid Services (CMS), the reasoning for the change is as follows: “In the Heart and Great Vessels body system, revise the device value External Heart Assist System to Short-term External Heart Assist System, and add the qualifier Intraoperative to table 02H, Insertion to clarify that these are short-term devices and to distinguish between procedures in which the device is used intraoperatively only, and procedures where the device remains in the patient at the conclusion of the procedure, and is removed anywhere from several hours to several days later. In addition, add the qualifier Biventricular to tables 02P and 02W, Removal and Revision in the Heart and Great Vessels body system, for the device value External Heart Assist System, to enable precise reporting of these procedures to remove or revise a biventricular external heart assist device.”
But these changes to the tables are not the only updates–new codes have been added as well. PCS code 02HA3RJ denotes Insertion of Short-term External Heart Assist System into Heart, Intraoperative, Percutaneous Approach. This code will join its predecessor, PCS code 02HA3RZ, Insertion of Short-term External Heart Assist System into Heart, Percutaneous Approach, in the MS-DRG category 215 (Other Heart Assist System Implant). As with all updates, coders should take care to review these changes so that they can spend the new fiscal year coding to the best of their abilities.