guide to the 2017 icd-10-pcs updates - the online...

Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I

JustCoding’s Guide to the 2017 ICD-10-PCS Updates focuses on all of the changes to ICD-10-PCS, including additions, revisions,

and deletions. Each new code is reviewed, informing coders about what they need to look for in documentation and which

procedures to train on.

In addition to presenting the new codes, this book examines what the changes mean for coders, clinical documentation

improvement specialists, and physicians. Author Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, highlights what terms and details

may need to be queried and provides an explanation of the procedures featured in the code set’s brand-new tables.

Guide to the 2017

ICD-10-PCS Updates

100 Winners Circle, Suite 300Brentwood, TN 37027www.hcmarketplace.com

JCICD10PC


025X0ZZ 3E0Q028

02PA4N

Z 6AB

B0BZ 024F07J 02C

X0ZZ 021208F

Guide to the 2017

ICD-10-PCS Updates

34624_MB331362_MB331770_JCICD10PC_Cover.indd 1 9/12/16 11:37 AM

JustCoding’s Guide to the

2017 ICD-10-PCS Updates

JCICD10PC_FINAL.indd 1 9/8/16 2:06 PM

JustCoding’s Guide to the 2017 ICD-10-PCS Updates is published by HCPro, a division of BLR.

Copyright © 2016 HCPro, a division of BLR

All rights reserved. Printed in the United States of America. 5 4 3 2 1

ISBN: 978-1-68308-122-7

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Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, AuthorSteven Andrews, EditorMelissa Osborn, Product DirectorErin Callahan, Vice President, Product Development & Content StrategyElizabeth Petersen, Executive Vice President, HealthcareMatt Sharpe, Production SupervisorVincent Skyers, Design Services DirectorVicki McMahan, Sr. Graphic DesignerJake Kottke, Layout/Graphic DesignReggie Cunningham, Cover Designer

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© 2016 HCPro JustCoding’s Guide to the 2017 ICD-10-PCS Updates | iii

Contents

About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . .v

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Chapter 1: Medical and Surgical . . . . . . . . . . . . . . . . 3

Table 021 . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Table 024 . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Table 025 . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Table 027 . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Table 02B . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Table 02C . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Table 02H . . . . . . . . . . . . . . . . . . . . . . . . . .10

Table 02L . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Table 02N . . . . . . . . . . . . . . . . . . . . . . . . . .12

Table 02P . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Table 02Q . . . . . . . . . . . . . . . . . . . . . . . . . .14

Table 02R . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Table 02S . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Table 02U . . . . . . . . . . . . . . . . . . . . . . . . . .17

Table 02V . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Table 02W . . . . . . . . . . . . . . . . . . . . . . . . . .19

Table 037 . . . . . . . . . . . . . . . . . . . . . . . . . .20

Table 03C . . . . . . . . . . . . . . . . . . . . . . . . . .21

Table 047 . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Table 04C . . . . . . . . . . . . . . . . . . . . . . . . . .23


iv | JustCoding’s Guide to the 2017 ICD-10-PCS Updates © 2016 HCPro

Table 05H . . . . . . . . . . . . . . . . . . . . . . . . . .24

Table 05P . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Table 05W . . . . . . . . . . . . . . . . . . . . . . . . . .26

Table 0SP . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Table 0SR . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Table 0SW . . . . . . . . . . . . . . . . . . . . . . . . . .29

Table 0WY . . . . . . . . . . . . . . . . . . . . . . . . . .30

Table 0XY . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Chapter 2: Administration . . . . . . . . . . . . . . . . . . . 31

Table 3E0 . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Chapter 3: Extracorporeal Therapies . . . . . . . . . . . . 33

Table 6AB . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Chapter 4: New Technologies . . . . . . . . . . . . . . . . . 35

Table X2A . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Table X2R . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Table XHR . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Table XNS . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Table XRG . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Table XW0 . . . . . . . . . . . . . . . . . . . . . . . . . .39


© 2016 HCPro JustCoding’s Guide to the 2017 ICD-10-PCS Updates | v

About the Author

Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, AHIMA-ap-

proved ICD-10-CM/PCS trainer, has been teaching healthcare

administration, health information management, and medical billing

and coding, both on-site and online, for more than a decade.

Safian writes a monthly Q&A column for JustCoding.com; is the

presenter for the webinar series, “Anatomy for ICD-10 Coders”;

and writes several articles each year on various aspects of coding

now and into the ICD-10 transition. She is also the author of sev-

eral textbooks, including Insurance Coding & Electronic Claims for

the Medical Office, The Complete Procedure Coding Book, The Com-

plete Diagnosis Coding Book, You Code It! A Case Studies Workbook,

Essentials of Health Care Compliance, and Foundations of Health Care

Administration.

Safian completed her PhD in healthcare administration in June

2011. In addition, she holds a graduate certificate in healthcare

management and a master’s degree in organizational management.

Safian has served on several committees and practice councils on

the national, state, and local levels of AHIMA, and has chaired the

Continuing Education committee for the Florida Health Information

Management Association (FHIMA). In 2015, she was named the

FHIMA Outstanding HIM Professional of the Year.


© 2016 HCPro JustCoding’s Guide to the 2017 ICD-10-PCS Updates | 1

Introduction

We have all had almost a year to work with ICD-10-PCS

for reporting inpatient facility services. It works dif-

ferently than our other code sets, such as ICD-10-CM

and CPT, but it provides us with a smoother path to the correct

code as we build, rather than find, the accurate representation of

what services were provided.

Now, the moratorium on code set changes has been lifted, and we

have our first block of code set changes in several years. The 2017

code set includes a total of 75,789 codes, a net increase of more

than 3,800 codes from 2016, with another 491 code titles revised.

Even though this sounds intimidating, a vast majority of these

changes occurred in tables for procedures on the heart and great

vessels. Due to the way ICD-10-PCS tables are built, a single new

character can result in dozens of new combinations.

This handbook is set up for coders to review what new reporting

options are available. It may be helpful to mark up your own ICD-

10-PCS book to note where new or revised options exist, to ensure

the appropriate details are being documented or queried.

To download a copy of the 2017 Official ICD-10-PCS Guidelines

and all tables, see www.cms.gov/Medicare/Coding/ICD10/2017-ICD-

10-PCS-and-GEMs.html.



1Medical and Surgical

Table 021

Section: Medical and Surgical

Body system: Heart and Great Vessels

Operation: BypassAlterations made to table 021:

BODY PART: The first change is one that is applicable through-

out this section (Chapter 4, Body Part). The word “site” has been

changed to “artery.” Previously, the list showed:

• 0, coronary artery, one site

• 1, coronary artery, two sites

• 2, coronary artery, three sites

• 3, coronary artery, four or more sites


4 | JustCoding’s Guide to the 2017 ICD-10-PCS Updates © 2016 HCPro

Chapter 1

DEVICE: The options for the sixth character on this row of the table

have a new choice, adding 8 (zooplastic tissue) in addition to the pre-

vious options.

DEVICE: Sixth-character 8 (zooplastic tissue) has been added to the

device options in other rows, as well.

BODY PART: A new row has been added to this table, providing the

opportunity to report bypasses performed on the pulmonary trunk or

pulmonary arteries.



Medical and Surgical

BODY PART: The 2016 table only has the option W (thoracic

aorta). The 2017 table has been revised to include W (thoracic

aorta, descending) and option X (thoracic aorta, ascending/arch) has

been added.

DEVICE: The options for the sixth character on this table, this row,

have an additional choice, adding 8 (zooplastic tissue) in addition to

the previous options.

Table 024Section: Medical and SurgicalBody system: Heart and Great Vessels Operation: CreationTable 024 is a new addition to the code set:

ROOT OPERATION: In the 2017 ICD-10-PCS guidelines, Creation

is now defined as “putting in or on biological or synthetic material to

form a new body part that, to the extent possible, replicates the ana-

tomic structure or function of an absent body part.” This procedure



Chapter 1

is limited, at this time, to the creation of new valves within the heart,

with options for the aortic, mitral, and tricuspid valves.

Table 025



Operation: DestructionAlterations to table 025:

BODY PART: The 2016 table shows W (thoracic aorta). In the

2017 table, this has been revised to W (thoracic aorta, descending),

and X (thoracic aorta, ascending/arch) has been added.




Table 027



Operation: DilationAlterations to table 027:

DEVICE: The options for the sixth character on this table in the first row

related to the coronary arteries have additional choices, providing quan-

tity specifications for the devices, in addition to the previous options.






Chapter 1

Table 02B



Operation: ExcisionAdjustments to table 02B:







Table 02C



Operation: ExtirpationAdjustments to table 02C:

QUALIFIER: On the first row, with regard to procedures provided

on the coronary arteries, seventh-character 6 (bifurcation) has been

added as an option.






Chapter 1

Table 02H



Operation: InsertionAdjustments to table 02H:

DEVICE: On the first row, N (intracardiac pacemaker) has been

added as an option.







Table 02L



Operation: OcclusionAdjustments to table 02L:

BODY PART: The fourth-character body part H (pulmonary valve)

has been added to the existing options.



Chapter 1

Table 02N



Operation: ReleaseAdjustments to table 02N:






JustCoding’s Guide to the 2017 ICD-10-PCS Updates focuses on all of the changes to ICD-10-PCS, including additions, revisions,

and deletions. Each new code is reviewed, informing coders about what they need to look for in documentation and which

procedures to train on.

In addition to presenting the new codes, this book examines what the changes mean for coders, clinical documentation

improvement specialists, and physicians. Author Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, highlights what terms and details

may need to be queried and provides an explanation of the procedures featured in the code set’s brand-new tables.

Guide to the 2017

ICD-10-PCS Updates

100 Winners Circle, Suite 300Brentwood, TN 37027www.hcmarketplace.com

JCICD10PC


025X0ZZ 3E0Q028

02PA4N

Z 6AB

B0BZ 024F07J 02C

X0ZZ 021208F

Guide to the 2017

ICD-10-PCS Updates

34624_MB331362_MB331770_JCICD10PC_Cover.indd 1 9/12/16 11:37 AM

guide to the 2017 icd-10-pcs updates - the online...

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