Coding Tip: New Technology Drugs FY 2018
Kim Carrier RHIT, CDIP, CCS, CCS-P
Director of Coding Quality Assurance
AHIMA Approved ICD-10-CM/PCS Trainer
New Technology-ICD-10-PCS Section “X” DRUGS
Section “X” is a separate place within ICD-10-PCS for certain new technology procedures (such as new technology drugs). Section “X” does not introduce any new coding concepts or unusual guidelines for correct coding and maintains continuity with the other sections in ICD-10-PCS. The same root operation and body part values are used in section “X” as in other sections. The seventh character in section “X” is used to indicate the new technology group. This is a number or letter that changes each year that new technology codes are added. It is only used to indicate the year the code was created and all codes for that update year will have the same qualifier. The new technology drugs for FY2018 will have the qualifier/seventh character of “3” since this is the third year of ICD-10-PCS.
Section “X” codes are standalone codes. No additional codes from other sections in ICD-10-PCS are necessary for reporting as the specific procedure is described in the code title from section “X”.
New Technology section codes are easily found by looking in the ICD-10-PCS Index or the Tables. The name of the new technology device, substance or technology for a section “X” code is included as the main term. They are also listed under the main term “New Technology”.
There were four new substance values added to the code table XW0 (anatomical regions, introduction) for FY 2018.
• A—Bezlotoxumab Monoclonal Antibody/ZINPLAVA
• B—Cytarine and Daunorubicin Liposome Antineoplastic/VYXEOS
• C—Engineered Autologous Chimeric Antigen Receptor T-Cell Immunotherapy/KTE-C19/axicabtagene ciloleucel/CAR-T therapy
• F—Other New Technology Therapeutic Substance
New Technology Drugs for 2018
Bezlotoxumab/ZINPLAVA—this drug is used in patients with Clostridium difficile (C. diff) diarrhea who are already on antibiotics and have a high risk of recurrence. Up to 25% of patients with C. diff will have a recurrence of the bacteria. Use of this drug helps to reduce recurrence of the bacteria. This drug is a human monoclonal antibody targeting the C. diff toxin B and does not affect the GI microbiota like the antibacterial drugs do. This drug is administered by IV.
Cytarabine/ and Daunorubicin/VYXEOS—this drug is used in patients with acute myeloid leukemia (AML). VYXEOS delivers and maintains fixed ratios of Cytarabine and Daunorubicin and provides prolonged exposure in the bone marrow. Both Cytarabine and Daunorubicin are existing chemotherapy drugs and are commonly used but VYXEOS is a specific formula of the two drugs. This is administered by IV.
Engineered Autologous Chimeric Antigen Receptor T-Cell Immunotherapy/KTE-C19/axicabtagene ciloleucel/CAR-T therapy—this engineered autologous immunotherapy is used to treat patients with relapsed or refractory B-cell non-Hodgkin lymphoma who are eligible for an autologous stem cell transplant. This represents a new paradigm in antineoplastic therapy. In this, the patient’s own T-cells are harvested and engineered to target specific antigens. After this is infused back into the patient, the genetically engineered T-cells find the target cells and kill them.
AHA ICD-10-CM/PCS Coding Clinic, Fourth Quarter 2017 Pages: 77-78
The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
In Parts 1, 2 and 3 we learned about what sepsis is, sequencing of sepsis and what documentation is needed to report severe sepsis. In Part 4, we will look at clinical indicators needed to clinically support the diagnosis of sepsis and determine if a query is indicated.
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In Part 2 of our Sepsis Series, we are going to focus on sequencing of sepsis when the diagnosis is clearly documented. Later in the series we will look at what to do when the diagnosis is not clearly documented.
In this series, we will learn what sepsis is or causes of sepsis, how to sequence the diagnosis in ICD-10-CM, what are the clinical indicators for sepsis, is a query necessary before reporting the diagnosis of sepsis, and how to prevent denials on sepsis records.
In the previous three parts of this four part series, we discussed the new ICD-10-CM diagnosis code changes, ICD-10-PCS procedure code changes and FY2020 IPPS changes. In this last Part 4 of the series, we will review the NTAP procedure codes and reimbursement add-on payments for FY2020.
In the previous two parts of this four part series, we discussed the new ICD-10-CM diagnosis code changes and ICD-10-PC procedure code changes. In this session we will review the major IPPS changes for FY2020. On August 2, 2019, CMS published the Final Rule for IPPS (CMS-1716) FY2020 IPPS Final Rule.
In Part 1 of this 4 part series we discussed some of the new ICD-10-CM diagnosis changes. In Part 2 we present the significant ICD-10-PCS procedure code changes. There are 72,184 total ICD-10-CM codes for FY2020.
This is Part 1 of a 4 part series on the FY2020 changes to ICD-10 and the IPPS. In this part, we discuss some of the new ICD-10-CM diagnosis changes. There are 72,184 total ICD-10-CM codes for FY2020.
We have finished with the step-by-step coding tidbits on coding of spinal fusions. If you were not able to catch Parts 1-13 of this series focused on spinal fusions, please visit hiacode.com/topics/series/spinal-fusion-coding/.
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In Part 8, we focused on identifying if a discectomy was performed, and if so, if it was a partial or a total discectomy. In Part 9, we are going to focus on identifying if a decompression was performed, and if so, was it of the spinal cord, spinal nerves or both?
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In Part 5, we focused on identifying the approach being used for the spinal fusion. In Part 6, we are going to focus on identifying the type of bone graft used for the spinal fusion.
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This past year, HIA implemented “Buddy Up,” a program designed to help the new hire have a smooth transition into their new HIA roles with the assistance of a “buddy.” What is a Buddy? The Buddy is simply a peer who can guide the new hire in order to make them feel more comfortable. We are very proud of this program and have many success stories that we would like to share. Take a look at the wonderful feedback we have received below.
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Part 3: Spinal Fusion Coding — Determine the Level(s) or Region of Fusion and Number of Vertebrae Fused
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We interviewed our most productive coders, reviewers and members of our education team, asking them what steps they take to find a rhythm that works for them. This week, we talked with Beth Martilik, MA, RHIA, CDIP, CCS, Assistant Director of Education, about the steps she takes to find her routine.
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