The Centers for Medicare & Medicaid Services (CMS) is implementing 34 new procedure codes into the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) which is effective from April 01, 2023.
- No deleted or revised codes in this update.
- No changes in the guidelines.
- 34 codes are added to the Medical and surgical, Administration and New technology sections.
Medical and Surgical section
REBOA - Resuscitative endovascular balloon occlusion of the aorta
REBOA is an endovascular procedure that has recently been advocated for control of uncontrolled torso hemorrhage below the diaphragm.
REBOA is an as a method of hemorrhage control because it can provide total occlusion of the aorta either just above the diaphragm (Zone I), to control intra abdominal bleeding, or above the aorto-iliac bifurcation (Zone III), to control bleeding in the pelvis. The REBOA catheter is inserted via a femoral artery sheath which can be placed via palpation of a pulse, using ultrasound, or by cut-down. It provides an alternative to aortic clamping or compression via a thoracotomy or laparotomy. It can also be performed in non-procedural areas such as the Emergency Room or even in the prehospital environment.
CMS added the two new codes with open approach 02L and 04L table with qualifier J-temporary. Percutaneous approaches for the same codes already exist in previous versions.
Laser Interstitial Thermal Therapy - LITT
CMS added many LITT procedures to many PCS tables in the October 1st updates.
But not added the LITT procedures for the vertebral bones associated with spinal tumors.
CMS added below 12 codes of LITT procedure codes for the vertebrae from this update.
Administration section
Intraosseous infusion:
- Intraosseous cannulation is the placing of a sturdy needle through cortical bone and into the medullary cavity to emergently infuse fluids and blood products into critically ill patients.
- This route is used when other venous access can not be established.
- This is not a bone marrow transplant, it is the transfusion of blood products through the veins inside the bone.
- Vascular constriction makes peripheral IV access hard to accomplish and can be even more difficult in children than in adults. IO access is a tool to provide immediate venous access that will not collapse during systemic shock or cardiopulmonary arrest.
- IO sites can be used for administration of blood, medication and fluids and drawing blood samples.
- Most common sites are proximal tibia in children and proximal tibia or humerus.
- Below 14 new codes have been added to the administration section for transfusion through bone marrow.
- These codes can be used with insertion of an infusion device from 0XH or 0YH insertion tables and body part would be Lower leg for proximal tibia , upper arm for proximal humerus based on access points. (The upper and lower bones won’t work)
New technology section
REGN COV2
New code has been added to the XW0 table for administration of REGN COV2 monoclonal antibody for the treatment of COVID-19 when administered into subcutaneous tissue using a percutaneous approach.
This drug was added in 2021, the qualifier value is 6, New Technology Group 6.
Sabizabulin (VERU 111)
Three new codes have been added for Sabizabulin, which is an oral combination of antiviral, anti-inflammatory drug to treat COVID-19.
These codes added to the table XW0 with substance value is K and Qualifier value is 8, New Technology Group 8.
Exagamglogene
Exagamglogene autotemcel (exa-cel; formerly known as CTX001) is a cell therapy to treat Beta-Thalasemia and sickle cell disease by modifying the patient’s blood cell precursor to form fetal hemoglobin that transport oxygen more efficiently than its adult equivalent.
These 2 new codes have been added to the XW1 table with substance value J and qualifier value is 8, New Technology Group 8.
References:
CMS: https://www.cms.gov/files/zip/icd-10-ms-drgs-v401-effective-april-1-2023.zip
