FY 2027 ICD-10-PCS Code Updates

The Center for Medicare and Medicaid Services has released the FY 2027 updates to the ICD-10-PCS code classification. This year’s updates are a little smaller than last year’s, with 101 codes being added.

The sections of ICD-10-PCS with new codes are:

ICD-10-PCS Coding Guidelines

The 2027 updates to the guidelines consist of capitalization changes in Conventions A6 and A7, the addition of examples in guidelines B3.3, B3.4a and B3.5 and a change of the word “assigned” to “coded” in guideline E.1a.

ICD-10-PCS Alphabetic Index

The addenda to the ICD-10-PCS index has 27 pages this year. Most of the entries added to or deleted from the index are related to changes in the tables such as the addition of new root operation, body part, device, substance or technology values, or the movement of devices and substances from one section of ICD-10-PCS to another. Some of the deletions and additions are made to correct errors.

One significant update is the change to the direction provided by the index when searching the term Cerament G. Previously, the index directed, “use of Antibiotic-eluting Bone Void Filler”. As of 2027, use of Cerament V, a second type of antibiotic-eluting bone void filler, is reportable with an ICD-10-PCS code, so the index entry for Cerament G has been revised to “use Gentamicin-eluting Bone Void Filler” and an entry was added for “Cerament V use Vancomycin-eluting Bone Void Filler”. These changes allow for more specific reporting based on the type of antibiotic included in the bone void filler product.

ICD-10-PCS Code Tables

The greatest number of updates are made within the code tables themselves, with both the Imaging and New Technology sections adding a new table. The number of tables with updates per section and the number of new tables being added to ICD-10-PCS is shown here.

Sample of Significant Updates

• LAMPOON Procedure – Body Part values F Aortic Valve and G Mitral Valve were added to code table 028 for the root operation Division in the Heart and Great Vessels body system. There are corresponding qualifier values of 0 Native Leaflet and 1 Prosthetic Leaflet for these body parts. These additions allow for reporting of the LAMPOON procedure, which is a minimally invasive technique that slices the anterior mitral leaflet to prevent a fatal blockage during transcatheter mitral valve replacement in patients unable to have open-heart surgery.
• Function Value, Decompression – Function value 7 Decompression and Qualifier value D Impellar pump were added to table 5A0 for body system value 5 Circulatory and Duration value 2 Continuous. This code will be used in conjunction with a code being added to table X2H for insertion of the eLym™ System used in the treatment of fluid overload or congestion in adult patients with acute decompensated heart failure. The code from table 5A0 will be used to report the continuous decompression taking place after the eLym system is inserted. Both codes will be needed to fully report the procedure.
• Fluorescein Retinal Angiography – New Table B85 is being added in the Imaging section for the Eye body system and the root type Other Imaging. The body part values are A Choroid, Right; B Choroid, Left; G Retinal Vessel, Right and H Retinal Vessel, Left. The contrast value is 2 Fluorescing Agent. This table is used to report fluorescein retinal angiography.
• Vagus Nerve Neurostimulator – Table XDH added Device value 5 Leadless Neurostimulator generator to the Body Part value Q Vagus Nerve to report insertion of a SetPoint Neurostimulator System for stimulation of the Vagus nerve to treat rheumatoid arthritis.
• Monitoring of Oxygen Saturation in GI System – New Technology Table XD2 Gastrointestinal System Monitoring is being deleted for 2027. This table was used to report Oxygen Saturation Endoscopic Imaging with the FUJIFILM EP-7000X System high-definition imaging platform.
• Single Use Scopes for Hepatobiliary Imaging – In New Technology table XFJ, Inspection of Hepatobiliary System and Pancreas, two new technology values are being added for body part values B Hepatobiliary Duct and D Pancreatic Duct. The first is B Single-use Cholangioscope, to identify the use of a single-use cholangioscope during ERCP procedures and the second is C Single-use Choledochoscope. Approach values percutaneous and percutaneous endoscopic are being added for use with this device value, to identify the use of a single-use choledochoscope during pancreaticobiliary system and hepatic duct procedures.
• CCM-D Therapy – In New Technology table XHH, Insertion of Skin, Subcutaneous Tissue, Fascia and Breast, a new device value is being added, J Contractility Modulation Device with Defibrillator Generator for body part value 8 Subcutaneous Tissue and Fascia, Chest and the Open approach, to allow for reporting of a single unique code to describe the insertion of a cardiac contractility modulation device with defibrillator. Codes for insertion of transvenous pacemaker and defibrillator leads in the right ventricle are also needed.
• Introduction of Substances – There are six new substances being added to the Introduction (XW0) table for New Technology Group 12:
  • Elamipretide – For improving muscle strength in adult and pediatric individuals with Barth syndrome.
  • Landiolol Antiarrhythmic – For the short-term reduction of ventricular rate in adults with supraventricular tachycardia.
  • Zimislecel Allogeneic Stem Cell-Derived Islet Cell Therapy – Investigational allogeneic stem cell-derived, fully differentiated, insulin-producing islet cell therapy aimed at restoring physiological insulin production in select people with type 1 DM.
  • Ifezuntirgene Inilparvovec – One-time gene therapy for the treatment of Huntington’s disease.
  • Recombinant Human Bone Morphogenetic Protein-2 with Collagen Scaffold – Recombinant human bone morphogenetic protein-2 (rhBMP-2) to actively induce formation of new bone and absorbable collagen sponge, which serves as a carrier for rhBMP-2 and a scaffold for bone growth.
  • Vancomycin-eluting Bone Void Filler – Implantable bone void filler consisting of hydroxyapatite, calcium sulfate and vancomycin. Prevents colonization of vancomycin-sensitive microorganisms to protect bone healing.

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