Will the updated code set change your inpatient coding? Find out! BY CLAIRE STEVENSON, CPC, CIC, COC, CPMA, CDEO, AND RENEE DUSTMAN, BS
The Centers for Medicare & Medicaid Services (CMS) recently released the ICD-10-PCS data set for fiscal year (FY) 2027. The update goes into effect Oct. 1, 2026. There are 101 new codes, three revised codes, and 38 deleted codes for inpatient coders to familiarize themselves with.
New Technology
There are 50 added codes in the New Technology section of ICD-10-PCS. This includes one new table (XEZ) and one new code in the X0H table for the insertion of a leadless neurostimulator generator into the vagus nerve through an open approach. The new XEZ table creates 10 new codes for other procedures on physiological systems and anatomical regions such as computer-aided guidance for intraprocedural navigation using ultrasound imaging with continuous needle tracking.
Other additions to the New Technology section are found in the following existing tables:
- X27 Dilation of Cardiovascular System
- New device value N Intraluminal Device(s), Small-diameter is added to identify dilation of lower leg arteries with a small-diameter peripheral vascular intraluminal device, creating six new codes.
- X28M3DC Division of Ventricular Septum using Transcatheter Septal Scoring Technique, Percutaneous Approach, New Technology Group 12
- X2H Insertion of Cardiovascular System
- Body part value 4 Innominate Vein, Left and device value M Temporary Intraluminal Device, Venous Angle Decompression Using Impeller Pump are added to create X2H43MC.
- X2R Replacement of Cardiovascular System
- Body part values F Aortic Valve, G Mitral Valve, and H Pulmonary Valve are added.
- Device value F Bioprosthetic Valve, Balloon-expandable with Dock is added.
- Device value L Zooplastic Tissue, with Integrated Native Leaflet Clipping Locators is added to describe transcatheter aortic valve replacement with this device.
- Device value G Synthetic Substitute, Size-Adjustable is added.
- X2V Restriction of the Cardiovascular System
- Body part values J Thoracic Aorta, Ascending and Arch and X Thoracic Aorta, Arch are added.
- Device value H Branched Intraluminal Device, Integrated System with Innominate Branch is added.
- Device value J Branched Intraluminal Device, Integrated System Extension is added.
- Device value K Branched Intraluminal Device, with Conical Collar is added.
- XFJ Inspection of Hepatobiliary System and Pancreas
- Technology value B Single-use Cholangioscope is added to identify the use of this device during endoscopic retrograde cholangiopancreatography (ERCP) procedures.
- Technology value C Single-use Choledochoscope is added to identify the use of this device during pancreaticobiliary system and hepatic duct procedures.
- XHH Insertion of Skin, Subcutaneous Tissue, Fascia and Breast
- New device value J Contractility Modulation Device with Defibrillator Generator is added to create XHH80JC.
- XRH Insertion of Joints
- New device value N Carbon/PEEK [Polyetheretherketone] Spinal Stabilization Device applies to cervical and thoracic joints.
- XW0 Introduction, Anatomical Regions
- New substance value C Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) with Collagen Scaffold is added, applied to joints.
- New substance value B Vancomycin-eluting Bone Void Filler is added, applied to bones.
- New substance values 4 Elamipretide percutaneously into subcutaneous tissue, 6 Landiolol Antiarrhythmic percutaneously into the peripheral vein or central vein, 7 Zimislecel Allogeneic Stem Cell-Derived Islet Cell Therapy percutaneously into the peripheral vein, and 5 Ifezuntirgene Inilparvovec percutaneously into the cranial cavity and brain.
- XXE Measurement of Physiological Systems
- Value H Cardiac Conduction Mechanism, Computer-aided Mapping for Planning is added to this table to identify the use of planning software to build a digital model of the conduction pathways.
Medical and Surgical Section
Table 028 Division of Heart and Great Vessels adds new body part values F Aortic Valve and G Mitral Valve, applied to new qualifier values 0 Native Leaflet and 1 Prosthetic Leaflet.
There are also several new codes added to tables 0RG and 0SG for various spinal fusion surgeries and a handful of codes added to table 0W9 Drainage.
Administration
In this section, you’ll find two new codes added to table 302 for transfusion of high-dose immune globulin into the central or peripheral vein and two new codes added to table 3E0 for introduction of an enzymatic/chemical agent into the skin and mucous membrane or subcutaneous tissue.
Extracorporeal or Systemic Assistance and Performance
In table 5A0, function value 7 Decompression and qualifier value D Impeller Pump apply to body system value 5 Circulatory and duration value 2 Continuous, to create new code 5A0527D Assistance with Circulatory Decompression using Impeller Pump, Continuous.
There are also three new codes added to table 5A1 Performance of Urinary Filtration to specify Intermittent, Less than 6 Hours Per Day; Prolonged Intermittent, 6-18 Hours Per Day; and Continuous Filtration Greater than 18 Hours Per Day.
Imaging Section
New table B85 Other Imaging of Eye houses four new codes for the right and left choroid and retinal vessels to identify retinal angiography using a fluorescing agent.
Revised Codes
Just a few New Technology codes were revised to reflect the drug’s latest name, as follows:
Deleted Codes
Several codes were deleted based on CMS’ analysis of Group 7 section X codes using frequency data and new technology add-on payment (NTAP) status from FY 2022, 2023, and 2024. Use the 2027 ICD-10-PCS Conversion Table file (see link below) to locate an existing code or a new code to use in place of a deleted code, if applicable.
Don’t Forget the Guidelines
You will find some basic housekeeping updates to the 2027 Official ICD-10-PCS Coding Guidelines at A6, A7, B3.3, B3.4a, B3.5, and E1.a.
Author’s Corner:
Claire Stevenson, CPC, CIC, COC, CPC-M, CPMA, CDEI, CDEO, is the medical coding quality analyst for AAPC’s publishing department. She has experience across a wide range of specialties, with special interest in both inpatient and outpatient surgical coding. Prior to joining AAPC, her career path included coding, auditing, education, and management.
Renee Dustman, BS, is the managing editor of content and editorial for AAPC’s Publishing Department. She is a member of the Flower City Professional Coders local chapter in Rochester, N.Y