Q&A: ICD-10-PCS codes for therapeutic Introductions

Q: Are there fiscal year (FY) 2021 ICD-10-PCS codes our coding team can use for Introductions of therapeutics for our inpatients with COVID-19?

A: Yes. In the FY 2021 IPPS final rule, CMS finalized the implementation of 12 new ICD-10-PCS codes for both a Transfusion or Introduction of therapeutics for hospitalized patients with COVID-19. These codes became effective with discharges on and after August 1, 2020.

In your case, the ICD-10-PCS codes available to use for these Introductions include:

• XW013F5, Introduction of other new technology therapeutic substance into subcutaneous tissue, percutaneous approach, new technology group 5
• XW033E5, Introduction of remdesivir anti-infective into peripheral vein, percutaneous approach, new technology group 5
• XW033F5, Introduction of other new technology therapeutic substance into peripheral vein, percutaneous approach, new technology group 5
• XW033G5, Introduction of sarilumab into peripheral vein, percutaneous approach, new technology group 5
• XW033H5, Introduction of tocilizumab into peripheral vein, percutaneous approach, new technology group 5
• XW043E5, Introduction of remdesivir anti-infective into central vein, percutaneous approach, new technology group 5
• XW043F5, Introduction of other new technology therapeutic substance into central vein, percutaneous approach, new technology group 5
• XW043G5, Introduction of sarilumab into central vein, percutaneous approach, new technology group 5
• XW043H5, Introduction of tocilizumab into central vein, percutaneous approach, new technology group 5
• XW0DXF5, Introduction of other new technology therapeutic substance into mouth and pharynx, external approach, new technology group 5

For reference, the following image shows all new ICD-10-PCS codes for these procedures as well as their predecessor code titles:

Per CMS, these procedure codes will afford the healthcare industry the ability to more accurately track the use of these drugs and their effectiveness in the inpatient setting. The 12 new ICD-10-PCS procedure codes listed are designated as non-OR and do not affect any major diagnostic category or MS-DRG assignment.

Editor’s note: Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, RHIA, lead medical coding specialist at the Washington State Health Care Authority located in Olympia, Washington, answered this question.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.