ICD-10-PCS 2021 Adds 544 New Codes

ICD-10-PCS 2021 Adds 544 New Codes

The 2021 ICD-10-PCS files are now available. Inpatient coders will have 544 new codes to work with beginning Oct. 1, 2020, as well as changes to tables and the index.

New PCS Codes

Additions include several codes for:

  • Insertion of radioactive element into various body sites, by various approaches
  • Fragmentation of various veins and arteries
  • Removal of external fixation devices in various sites, by various approaches
  • Fusion of various joints using various approaches
  • Other imaging of various organs and body sites using a fluorescing agent
  • Low dose rate brachytherapy
  • Introduction of various biologics, intravenously

There are no revised titles or delete codes in this update.

Guideline Changes

The 2021 ICD-10-PCS Official Guidelines for Coding and Reporting are also available. There are minimal changes.

New guidelines B3.18 and B5.2b were added and B3.1b and B3.10c were revised, as such:

Excision/Resection followed by replacement

B3.18

If an excision or resection of a body part is followed by a replacement procedure, code both procedures to identify each distinct objective, except when the excision or resection is considered integral and preparatory for the replacement procedure.

Examples: Mastectomy followed by reconstruction, both resection and replacement of the breast are coded to fully capture the distinct objectives of the procedures performed. Maxillectomy with obturator reconstruction, both excision and replacement of the maxilla are coded to fully capture the distinct objectives of the procedures performed. Excisional debridement of tendon with skin graft, both the excision of the tendon and the replacement of the skin with a graft are coded to fully capture the distinct objectives of the procedures performed. Esophagectomy followed by reconstruction with colonic interposition, both the resection and the transfer of the large intestine to function as the esophagus are coded to fully capture the distinct objectives of the procedures performed.

Examples: Resection of a joint as part of a joint replacement procedure is considered integral and preparatory for the replacement of the joint and the resection is not coded separately. Resection of a valve as part of a valve replacement procedure is considered integral and preparatory for the valve replacement and the resection is not coded separately.

Percutaneous endoscopic approach with extension of incision

B5.2b

Procedures performed using the percutaneous endoscopic approach, with incision or extension of an incision to assist in the removal of all or a portion of a body part or to anastomose a tubular body part to complete the procedure, are coded to the approach value Percutaneous Endoscopic.

Examples: Laparoscopic sigmoid colectomy with extension of stapling port for removal of specimen and direct anastomosis is coded to the approach value percutaneous endoscopic. Laparoscopic nephrectomy with midline incision for removing the resected kidney is coded to the approach value percutaneous endoscopic. Robotic-assisted laparoscopic prostatectomy with extension of incision for removal of the resected prostate is coded to the approach value percutaneous endoscopic.

B3.1b [revised to remove the exceptions note]:

Exceptions: Mastectomy followed by breast reconstruction, both resection and replacement of the breast are coded separately.

B3.10c [revised text in bold)

  • If an interbody fusion device is used to render the joint immobile (containing bone graft or bone graft substitute), the procedure is coded with the device value Interbody Fusion Device

Downloadable Files

The 2021 ICD-10-PCS files are available for download on the Centers for Medicare & Medicaid Services’ website.

Certified Inpatient Coder CIC

Renee Dustman
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Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 20 years experience in print production and content management. Follow her on Twitter @dustman_aapc.

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