Centers for Medicare and Medicaid Services has updated FY 2023 ICD-10–PCS codes, coding methods, and documenting guidelines. This update was effective October 20, 2022, and will continue through the calendar year 2023. The total number of ICD-10-PCS codes in 2023 will be 78,496. It includes 64 new codes and 331 deleted codes. These changes can be a challenge for medical billing service providers and coding services. They can impact the payment of inpatient facilities such as skilled nursing homes, long-term care facilities, and residential/home healthcare services. CMS Version Update outline: CMS includes an associate degree total of 2023 PCS code updates.
CMS: Section-by-section detailed listing of CMS updates and codes
Summary table updated for 2023
| Total Codes 2022 | New Codes | Codes Revised | Deleted Codes | Total New Codes 2023 |
| 78,229 | 331 | 0 | 64 | 78,496 |
Specialty and other ICD-10-PCS Code Totals for 2023
| Specialties and subspecialties | Changes in numbers |
| Obstetrics | 304 |
| Medical and Surgical | 68,024 |
| Radiation Therapy | 2,056 |
| Physical Rehabilitation and Diagnostic Audiology | 1,380 |
| Placement | 861 |
| Administration | 1,257 |
| Measurement and Monitoring | 422 |
| New Technology | 297 |
| Substance Abuse Treatment | 59 |
| Mental Health | 3030 |
| Nuclear Medicine | 463 |
| Imaging | 2,978 |
| Chiropractic | 90 |
| Other Procedures | 78 |
| Osteopathic | 100 |
| Extracorporeal or Systemic Therapies | 45 |
| Extracorporeal or Systemic Assistance and Performance | 51 |
| Total | 78,496 |
Notable changes to the ICD-10-PCS code
New codes for optical maser opening thermal medicine care (LiTT):
Many new codes are available to destroy and treat various anatomical regions. These codes include optical maser opening thermal medicine (LiTT), a minimally invasive procedure for patients with drug-resistant brain disorders seizures. LiTT is the use of an optical maser radio-controlled via MRI to target and eliminates a small portion of brain tissue. LiTT might also be recommended for individuals with recurrent seizures in one area of their brain. These seizures square measure called focal seizures. These codes will replace the existing codes that are less specific for coverage LITT. For example, D0Y0KZZ has been replaced by 00500Z3.
It is important to note that the LITT codes have been moved from the radiation section to Medical and Surgical. This modification was made because the LITT procedure thermal medical care to kill soft tissue victimization heat generated from an optical maser probe, and not radiation is now possible.
New codes have been added to the Medical and Surgical Sections.
- The neural structure can be extracted for procedures such as cavitron unhearable surgery (CUSA) for brain tumors.
- Embolization procedures: Prostatic artery obstruction.
- Transferring large/small organs to a bladder/ureter.
- Revision and Removal of the Infusion Device from the os. These procedures are for antecedently inserted devices such as an Ommaya reservoir.
- Drainage of the neck using a natural or synthetic gap or natural or artificial gap scrutiny approach to voidance parapharyngeal and retropharyngeal infections employing a medical tool.
Additional codes are available in the updated ICD-10 PCS code set for therapeutic agents and a variety of vein introduction codes.
Updates in the New Technology Section: There are many new codes and some deletions to the ICD-10-PCS codes set for FY 2023. The ISS500 neurologic device is indicated to increase cerebral blood flow and reduce incapacity in adults with acute stroke. 01HY3MZ is no longer used to report the implantation of a sphenopalatine neuro structure stimulator for stroke.
For specific procedures, new codes are being developed
- Implantation of the Sphenopalatine neural structural stimulator for ischemia.
- Paired wandering Nerve Stimulation medical aid victimization associate External controller.
- Computer-Assisted Transcranial Magnet Stimulation of the Anterior Cortex.
- Liver histotripsy.
- Procedures for posterior bone tether.
- Insertion of Bones and Fusion In Joints for Internal Fixation Devices.
- Insertion in joints of posterior spinal motion preservation devices.
- Replacing the medial and lateral gristle.
- Extracorporeal Antimicrobial administration during urinary organ replacement.
- Introduce drugs.
- Measurement techniques.
Changes to the ICD-10-PCS Coding Guideline for 2023
The FY 2023 ICD-10–PCS pointers are for coding, documentation, and reporting. The FY 2023 rules have been updated.
New Root Operation guideline B3.19 and two revised sections on detachment of extremities
- The general guideline for Body Part B4.1c.
- Device general guideline B6.1a.
- Revision to General Guideline B4.1c clarifies the meaning of having a “continuous portion of a hollow body section.”
B4.1c FY 2022 Guidelines:
“Code the hollow section that is the most proximal anatomically (closest to your heart) if a procedure is being performed on it.”
FY 2023 B4.1c Rev.
“Code the body part that is closest to the heart.
Device General Guideline B6.1a states that coded tools are only valid if the tool is still in use after the procedure is complete. The device is considered to be worthless if it does not exist. It informs coders that a tool should be removed after the procedure is over, but it must still be inserted before the end of the operative episode.
CMS has provided 2023 ICD-10PCS Official Pointers for Cryptography and Coverage. They highlight the importance of accurate clinical documentation and note: “These pointers were developed to assist each the care provider and the technologist in identifying those procedures that area unit reportable. It cannot be stressed enough how important it is to have consistent and complete documentation in the case history. Without such documentation, correct cryptography is impossible.”
Correct cryptography using the ICD-10 requires documentation within the patient’s records. To confirm that the ICD-10 is being used correctly, medical coding outsourcing companies need to have detailed documentation. This allows them to provide better patient care and prompt hospital claims payments.
Novita Management, a medical coding outsourcing company, keeps up-to-date with the latest updates and continuously educates and trains its coding team. Our coding quality auditors are attentive to coding denials and ensure that the first pass rate is higher.