CMS to Give More Details on ICD-10-PCS Section X in June

by | Last updated Jun 29, 2023 | Published on Jun 19, 2015 | Medical Coding

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Concerns regarding reporting new technologies, drugs and supplies led to the creation of Section X in ICD-10-PCS set for implementation on October 1, 2015. These concerns raised at the September 2014 meeting prompted the ICD-10 Coordination and Maintenance Committee (C&M) to discuss the proposal during its March meeting. Now, CMS plans to give more details on Section X during a National Provider Call scheduled on June 18.

The C&M committee said the actual goal of Section X is to create codes that:

  • Uniquely identify procedures requested through the New Technology Application Process or that which capture services that are not routinely captured in ICD-10-PCS and have been presented for public comment at a C&M meeting
  • Maintain continuity with the other sections in ICD-10-PCS

Similar to the general structure of ICD-10-PCS, each of the seven characters with a Section X code has a consistent definition within the section. To be more specific, each character will represent a value like this:

  • First character – letter X
  • Second character – body system/region
  • Third character – root operation
  • Fourth character – body part
  • Fifth character – procedure approach
  • Sixth character – device/substance/ technology
  • Seventh character – information indicting the year created

However, the final decisions will be made by the C&M committee after considering public comment.

When the C&M committee proposed Section X to capture the use of new technology and complex drugs and supplies, the AAPC voiced its opinions against this. According to the AAPC, making these changes effective with ICD-10-PCS implementation in October 1 can add complexity and burden to facilities preparing for ICD-10 transition. Most facilities are in their final rounds of setting up enterprise systems and protocols, internal and external end-to-end testing and staff training. Moreover, addition of a new section presents many problems. Section X codes will be separate from the rest of the code set and offer less granularity compared to the proposed X character (in C&M meeting), that can be added to any code. As the new codes in the section work their way through the Coordination and Maintenance process, it will be harder to track the quickening development pace of new technologies. There is increased chance for the codes to become redundant when other sections’ codes are introduced. AAPC advocated for the proposed X character instead of an entire X section.

CMS National Provider Call in June may give a better explanation for these concerns. Registration for this call is limited, and it is expected to discuss various other aspects of ICD-10 such as an implementation update, preparation strategies, a testing update, and provider resources. There will be a question and answer session after the presentations.

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