NEWS ALERT: CMS Releases PCS Codes Final Rule

The final rule contains 78,220 code changes, up by 117 from FY 2021.

The Centers for Medicare & Medicaid Services (CMS) has released the final ICD-10-PCS codes and guidelines for the 2022 fiscal year (FY).

The files included in the release include the Addenda File, Code Tables and Index file, FY 2022 PCS Version Update Summary, Order File, Codes File, and Conversion Table, in addition to the FY 2022 ICD-10-PCS guidelines.

The changes to the classification between FY 2021 and FY 2022 are shown below:

Section

FY21

FY22

Net Changes

Medical and Surgical

67,655

67,754

+99

Obstetrics

304

304

0

Placement

861

861

0

Administration

1,336

1,253

-83

Measurement & Monitoring

421

422

+1

Extracorporeal or Systems Assistance

51

52

+1

Extracorporeal or Systems Therapies

46

46

0

Osteopathic

100

100

0

Other Procedures

78

78

0

Chiropractic

90

90

0

Imaging

2,973

2,977

+4

Nuclear Medicine

463

463

0

Radiation Therapy

2,087

2,087

0

Physical Rehabilitation and Audiology

1,380

1,380

0

Mental Health

30

30

0

Substance Abuse

59

59

0

New Technology

169

264

+95

Grand Total

78,103

78,220

+117

The ICD-10-PCS FY 2022 guidelines represent changes in B3.7 (control versus more definitive root operations); B4.1c (general guidelines for body part); B4.8 (upper and lower intestinal tract); and E1.a and E1.b (general guidelines for new technology).  

CMS has included a new PDF file for the ICD-10-PCS Index and code tables, which is being recreated by many coding book publishers. The conversion table is used to map data from FY 2021 to FY 2022 (and the reverse). The Order File is used by code developers. The addenda file is the file that you’ll want to review to see the specific changes in procedure codes for FY 2022.  

Programming Note:

Listen to Laurie Johnson report on this story live on Talk Ten Tuesdays, coming up on Tuesday, June 8 at 10 a.m. EST.

Resources:

Guidelines:  https://www.cms.gov/files/document/2022-official-icd-10-pcs-coding-guidelines.pdf

 

New Codes:  https://www.cms.gov/medicare/icd-10/2022-icd-10-pcs

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