Final FY21 ICD-10-PCS Codes Are Here

The FY21 ICD-10-CM codes will be finalized this month.

The Centers for Medicare and Medicaid Services (CMS) released the final FY21 ICD-10-PCS codes on May 28, 2020 which was earlier than expected. The table below will show the changes between Final FY20, Proposed FY21, and Final FY21:

Section	FY20	Proposed FY21	Final FY21	Change FY20 – FY21
Medical & Surgical	67,257	67,380	67,655	398
Obstetrics	302	302	304	2
Placement	861	861	861	0
Administration	1,332	1,332	1,336	4
Measurement & Monitoring	418	419	421	3
Extracorporeal/Systemic Assistance & Performance	48	49	51	3
Extracorporeal/Systemic Therapies	46	46	46	0
Osteopathic	100	100	100	0
Other Procedures	77	78	78	1
Chiropractic	90	90	90	0
Imaging	2,941	2,969	2,973	32
Nuclear Medicine	463	463	463	0
Radiation Therapy	2,019	2,083	2,087	68
Physical Rehabilitation & Diagnostic Audiology	1,380	1,380	1,380	0
Mental Health	30	30	30	0
Substance Abuse Treatment	59	59	59	0
New Technology	136	142	169	33
Totals	77,559		78,103	544

This table will assist you in determining where to focus education and facility guideline updates. In the Medical and Surgical Section, the root operation, Fragmentation, was added to several systems with percutaneous approach and ultrasonic qualifier.The device, Radioactive Element, was added to Central and Peripheral Nervous Systems; Ear, Nose, and Throat; Mouth and Throat; Gastrointestinal; Hepatobiliary System and Pancreas; Endocrine; Urinary; Female Reproductive; and Male Reproductive systems. A contractility modulation device was added to the Subcutaneous and Connective Tissue section. The external fixation device was added to the 0QP Table. An internal fixation device with sustained compression was added to Fusion for Lower Joints and Upper Joints. The root operation, Transplantation, was added to the Male Reproductive System.

In the Imaging Section, a fluorescing agent was added to contrast and bacterial autofluorescence was added to Qualifier options to some tables. Radiation Therapy added isotope of Cesium 131. The New Technology Section added new devices and new substances such as the following:

Brexanolone
Nerinitide
Durvalumab (Anti-neoplastic)
Lefamulin Anti-infective
Synthetic Substitute Mechanically Expandable
Cerebral Embolic Filtration, Extracorporeal Flow Reversal Circuit
Mineral-based Topical Hemostatic Agent
Eladocagene exaparvovec
Brexucabtagene Autoleucel Immunotherapy
Lisocabtagene Maraleucel Immunotherapy
Infection, Positive Blood Culture Fluorescence Hybridization for Organism Identification, Concentration, and Susceptibility
Infection, Lower Respiratory Fluid Nucleic Acid-base Microbial Detection

The New Technology additions give us a glimpse into possible New Technology Add-On Payments for FY21.

It is important to review these updates and determine if there are any changes in coding processes as well as identifying documentation in the electronic medical record which is applicable to the new procedures. It is also important to update your facility guidelines if any changes are made in the coding process. Keep a version for FY20 so the applicable guidelines can be matched to the dates of service during a coding review or regulatory audit.

The FY21 ICD-10-CM codes will be finalized this month. The Final Rule for FY21 will be expected by August 7, 2020. More changes are on the way.

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Photo courtesy of: ICD10 Monitor

Originally Published On: ICD10 Monitor

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