A summary of the modifications to the ICD-10-PCS Official Guidelines for Coding and Reporting is included below. The complete guidelines may be downloaded by visiting https://www.cms.gov/medicare/icd-10/2022-icd-10-pcs.
The modifications are published below using the following format:
Narrative changes appear in bold text (e.g., more definitive root operation).
Items underlined were moved within the guidelines since October 1, 2021
(e.g., control of acute bleeding). Deletions are shown as strikeouts (e.g., any of the definitive root operations).
Medical and Surgical Section Guidelines (section 0)
B3. Root Operation . . .
Control vs. more definitive specific root operations
The root operation Control is defined as, “Stopping, or attempting to stop, postprocedural or other acute bleeding.” If an attempt to stop postprocedural or other acute bleeding is unsuccessful, and to stop the bleeding requires performing a more definitive root operation, such as Bypass, Detachment, Excision, Extraction, Reposition, Replacement, or Resection, then the more definitive root operation is coded instead of Control. Control is the root operation coded when the procedure performed to achieve hemostasis, beyond what would be considered integral to a procedure, utilizes techniques (e.g., cautery, application of substances or pressure, suturing or ligation or clipping of bleeding points at the site) that are not described by a more specific root operation definition, such as Bypass, Detachment, Excision, Extraction, Reposition, Replacement, or Resection. If a more specific root operation definition applies to the procedure performed, then the more specific root operation is coded instead of Control.
Example: Resection of spleen to stop bleeding is coded to Resection instead of Control Silver nitrate cautery to treat acute nasal bleeding is coded to the root operation Control.
Example: Liquid embolization of the right internal iliac artery to treat acute hematoma by stopping blood flow is coded to the root operation Occlusion.
Example: Suctioning of residual blood to achieve hemostasis during a transbronchial cryobiopsy is considered integral to the cryobiopsy procedure and is not coded separately.
B4. Body Part . . .
If a procedure is performed on a continuous section of a tubular body part, code the body part value corresponding to the furthest anatomical site from the point of entry anatomically most proximal (closest to the heart) portion of the tubular body part.
Example: A procedure performed on a continuous section of artery from the femoral artery to the external iliac artery with the point of entry at the femoral artery is coded to the external iliac body part. A procedure performed on a continuous section of artery from the femoral artery to the external iliac artery with the point of entry at the external iliac artery is also coded to the external iliac artery body part.
Upper and lower intestinal tract
In the Gastrointestinal body system, the general body part values Upper Intestinal Tract and Lower Intestinal Tract are provided as an option for the root operations such as Change, Insertion, Inspection, Removal and Revision.New Technology Section Guidelines (section X)
E. New Technology Section
Example: XW04321 Introduction of Ceftazidime-Avibactam Anti-infective into Central Vein, Percutaneous Approach, New Technology Group 1, can be coded to indicate that Ceftazidime-Avibactam Anti-infective was administered via a central vein. XW043A6 Introduction of Cefiderocol Anti-infective into Central Vein, Percutaneous Approach, New Technology Group 6, can be coded to indicate that Cefiderocol Anti-infective was administered via a central vein.