Get Ready for the 2020 ICD-10-PCS Deletions, Additions, Revisions, and Guideline Changes

Posted on 25 Jun, 2019 |comments_icon 0|By Bruce Pegg

If you’re an inpatient hospital coder, you’ve got some good news coming your way. Beginning on Oct. 1, 2019, you’ll have 1,322 fewer ICD-10-PCS codes to deal with. That’s because the number of deleted procedure codes — 2,056 in all — far outnumber the 734 additions to the 2020 code set.

Additionally, you’ll find only two revised codes this time around, which should also help to make your job somewhat easier.

Here are some of the significant changes, along with the main guideline revisions, that may affect your coding in just a few months.

Watch for Numerous Upper and Lower Artery Dilation Deletions

Unsurprisingly, as the section contains the largest number of codes, the largest number of deletions comes from the Medical and Surgical codes. The changes include more than 800 code deletions from the 037 Upper Arteries Dilation table and a similar number from the 047 Lower Arteries Dilation table. Other large deletions come from the 03C Upper Arteries Extirpation table (89 codes) and the 04C Lower Arteries Extirpation table (88 codes).

Smaller, yet significant, deletions come from the Skin and Breast codes, especially from the tables for 0H0 Skin and Breast Alteration, 0H9 Skin and Breast Drainage, 0HB Skin and Breast Excision, 0HP Skin and Breast Removal, 0HR Skin and Breast Replacement, 0HU Skin and Breast Supplement, and 0HW Skin and Breast Revision.

Outside of the Medical and Surgical codes, the biggest single block of deleted codes comes from the 302 Administration Circulatory Transfusion table, where there are 127 deleted codes involving transfusions into the peripheral and central arteries.

Learn New Bypass, New Technology, and Brachytherapy Codes

The bulk of the additions, as you would expect, also come from the Medical and Surgery codes. The most significant look like this:

  • Table 031 Upper Arteries Bypass (38 changes)
  • Table 03V Upper Arteries Restriction (26 changes)
  • Table 09U Ear, Nose, Sinus Supplement (164 changes)
  • Table 0D1 Gastrointestinal System Bypass (143 changes)
  • Table 0HR Skin and Breast Replacement (22 changes).

Other notable ICD-10-PCS code additions include 12 new Administration Circulatory Transfusion codes for table 302, 16 new Other Procedures Physiological Systems and Anatomical Regions Other Procedures codes for table 8E0, and a new X27 New Technology Cardiovascular System Dilation table with 43 new codes.

Brachytherapy radiation therapy also receives some significant additional codes for most body systems, especially 19 new codes for the DW1 Radiation Therapy Anatomical Regions Brachytherapy table, 12 new codes for the D91 Radiation Therapy Ear, Nose, and Throat Brachytherapy table, and 9 new codes for the D71 Radiation Therapy Lymphatic and Hematologic System Brachytherapy table.

Rejoice with Only 2 Code Revisions

The New Technology codes also feature the only two revisions in this year’s round of changes, with the words “inhibitor reversal agent” being removed from XW03372, which now reads “Introduction of Inactivated Coagulation Factor Xa into Peripheral Vein, Percutaneous Approach, New Technology Group 2,” and XW04372, which is now “Introduction of Inactivated Coagulation Factor Xa into Central Vein, Percutaneous Approach, New Technology Group 2.”

Don’t Forget the Guidelines

In addition to the added, deleted, and revised codes, the 2020 ICD-10-PCS update also features some changes to the official guidelines.

To accompany the additions to the brachytherapy codes, the Centers for Medicare and Medicaid Services (CMS), the National Center for Health Statistics (NCHS), and the U.S. Federal Government’s Department of Health and Human Services (DHHS) have provided a new guideline section, Section D, Radiation Therapy, which contains specific instructions for coding implanted and applicator brachytherapy sources. As a result, the New Technology guidelines have been revised and moved to another new section, E.

CMS, NCHS, and DHSS have also revised several sections of the Medical and Surgical section guidelines, so be sure to review them if they apply to you.

Learn More

You can view the full 2020 ICD-10-PCS code set and download the zip file “2020 ICD-10-PCS Code Tables and Index” CMS also provides the 2020 ICD-10-PCS Guidelines in PDF format for convenient access.


Bruce Pegg
Editor, Newsletters

An experienced teacher and published author, Bruce is TCI’s new voice of primary care, delivering advice and insights every month for coders in the fields of family, internal, and pediatric medicine through Primary Care Coding Alert and Pediatric Coding Alert. Additionally, he is the current editor of E/M Coding Alert. Bruce has a Bachelor of Arts degree from Loughborough University in England and a Master of Arts degree from The College at Brockport, State University of New York. He recently became a Certified Professional Coder (CPC®), credentialed through AAPC.

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