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When I think back on all of the road trips I went on with my family when I was a child, I don’t remember how many miles we drove. We once traveled from Arizona to West Virginia – quite a long trek across the country. But what I do remember are the stops we made, or the significant tourist attractions we passed, like the Gateway Arch in St. Louis and the Lincoln Memorial. 

How is this relevant to the 2017 code updates, you ask? 

Most of us have probably been reading and hearing about the magnitude of the 2017 ICD-10-PCS code changes of late. But does it really matter? What I mean is, does it really matter how many new and updated codes there are for 2017? And how much should we focus on it?

In the coding department, I don’t think it matters much at all. Truthfully, when I began my review of the 2017 code changes, it seemed like a pretty daunting task given the sheer number of new codes that I had to review. But I quickly noticed – and this especially applies to PCS – that patterns emerged, and what once seemed to be a huge, daunting task became something manageable that actually made sense. 

It’s no secret that the majority of the PCS code changes, deletions, and additions for 2017 can be found in the cardiovascular tables. These changes are going to specifically affect stent placement and CABG coding. We will be going back to the “old” ICD-9 way of coding CABGs and stent insertions – by counting arteries and number of stents by stent type. 

Coders who worked in ICD-9 will remember this well. There may be some coder frustration with this change back to the old way of coding, as it was quite an adjustment to learn the “ICD-10 way” of CABG and stent insertion coding. The good news with this, however, is that most coders will be fairly comfortable going back to counting arteries and number of stents. The significance of this revision means that coronary artery anatomy review will be an important piece of coder preparation, because coding the placement of two stents placed in different portions of the LAD today will be different on or after Oct. 1, 2017. 

During my review, I noted overall that individual character changes span multiple tables in PCS. I also noted that some of these code changes/updates are rather small. Let me give you one example: body part character W, which right now represents  the thoracic aorta, has been changed  for 2017 to represent the thoracic aorta, descending.  A new body part character, X, has been added, which will represent the thoracic aorta, ascending. That’s a fairly small character change, yet it creates hundreds of new code combinations across at least 13 PCS tables.

Much like focusing on every mile of that long 3,000-mile road trip would sound daunting, focusing on the actual number of new and updated codes in ICD-10-PCS would be equally tedious. Isn’t it easier just to remember the experiences you had on a road trip? 

When educating coders or learning about these PCS code changes, additions, and deletions for yourself, consider focusing on the concepts and finding the patterns of changes in the PCS code tables. In adjusting our focus, these code changes will make more sense and seem more like a friend than a foe, since we will most likely endure many similar code updates and changes to come for the foreseeable future.


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