Health Information Management

Should your outpatient coders be preparing for ICD-10-PCS?

APCs Insider, March 14, 2014

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Hospitals and physicians will still continue to report CPT® codes for payments for outpatient procedures after ICD-10 is implemented, but that does not mean it will be the only code set they use.

Some organizations will have outpatient coders use ICD-10-PCS—the new procedure codes that replace ICD-9-CM Vol. 3—in addition to CPT, either to unify data collection efforts or due to requirements from non-government payers.

While ICD-10-CM features many more codes than ICD-9-CM, it follows many of the same processes for coding as its predecessor. However, ICD-10-PCS is an entirely new system and much more complicated than the system currently used by inpatient coders.

Switching to ICD-10-PCS will result in inpatient coder productivity declines, with estimates ranging from 25 to 60% at the last AHIMA conference. But the added specificity greatly exceeds the outgoing system, and often CPT as well.

For example, in ICD-9-CM procedure coding, to report a peripherally inserted central catheter (PICC) line, coders use 38.93 (venous catheterization, not elsewhere classified), the same code used to report a central venous catheter insertion.

ICD-10-PCS includes codes such as 02HV33Z (insertion of infusion device into superior vena cava, percutaneous approach), allowing facilities to capture information such as the type of device used, the approach, and where the PICC line ends.

CPT often falls somewhere in the middle. Code 36568 (insertion of PICC, without subcutaneous port or pump; younger than 5 years of age) captures some of the same information, as well as offering an additional code for patients older than 5.

Hospitals could benefit from having standardized data across the inpatient and outpatient departments. They could easily search for every procedure performed on a certain body part, or every instance of a device being used, at the facility. It would also allow easier collection of procedure data for statistics for credentialing.

Unless your organization is required to report both CPT and ICD-10-PCS codes, however, it could be an added burden while attempting to just get outpatient departments ready for ICD-10-CM. On the other hand, it could pay dividends down the line by allowing outpatient coders to seamlessly transition to the inpatient side.

Is your outpatient department planning to use both code sets after October 1? Let us know by voting in the poll below. 

Will your facility be coding in both ICD-10-PCS and CPT for either data collection or non-government payers after October 1? 

Click here and scroll to the bottom of the page to vote.


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