News: CMS releases FY 2020 ICD-10-PCS code set and Guidelines, calls for new measures

CMS released the fiscal year (FY) 2020 ICD-10-PCS changes on Friday, May 31, which include two code revisions, 734 additions, and 2,056 invalidations, Revenue Cycle Advisor reported.

The updates take effect with discharges occurring from October 1, 2019, through September 30, 2020. This year’s update cuts the total number of ICD-10-PCS codes by just over 1,000 codes (78,881 in 2019 versus 77,559 in 2020).

It also released the Official Guidelines for Coding and Reporting for the procedural coding system. These guidelines are “a set of rules … developed to accompany and complement the official [PCS coding] conventions and instructions provided within the ICD-10-PCS itself. They are intended to provide direction that is applicable in most circumstances.”

The update to the code set added a significant amount of new Bypass codes, as well new codes for various replacement, insertion, and transfusion procedures, according to Revenue Cycle Advisor.

The update also invalidated many ICD-10-PCS codes, most of which were for dilation procedures. 

Though they haven’t announced a date, CMS typically releases the ICD-10-CM update within a few weeks of the ICD-10-PCS update.

CMS also opened the call for new measures for the Medicare Promoting Interoperability Program under the Inpatient Prospective Payment System (IPPS). Under the program, eligible hospitals and critical access hospitals (CAH) are required to report certain measures with performance-based scoring at the individual measure-level. Scores for each of the individual measures are added together to calculate a hospital’s Promoting Interoperability score of up to 100 possible points, according to Revenue Cycle Advisor.

CMS is interested in adding measures that:

• Align with the Promoting Interoperability Performance Category for Merit-based Incentive Payment System-eligible clinicians
• Build on the advanced use of certified EHR technology
• Promote interoperability and health information exchange
• Focus on patient access to health information
• Improve program efficiency and flexibility
• Reduce provider burden

According to CMS, applicants should also consider:

• Health information technology (IT) activities
• Measurable outcomes demonstrating greater efficiency in costs that can be linked to the use of health IT
• Potential new opioid prevention and treatment related measures

Detailed information on the proposal submission process can be found here. Proposals must be submitted by June 28 to be considered for future rulemaking.

Editor’s note: To read Revenue Cycle Advisor’s coverage of the ICD-10-PCS update, click here. To download the new code files, visit the CMS website. To read Revenue Cycle Advisor’s coverage of the call for measures, click here.