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New ICD-10-CM and ICD-10-PCS Codes Announced For January 1, 2021

Summary

New International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and Procedure Coding System (ICD-10-PCS) codes have been released with an effective date of January 1, 2021. The new codes are related to reporting COVID-19 conditions and services.

The ICD-10-PCS codes have been released on the Centers for Medicare & Medicaid Services (CMS) website. The Centers for Disease Control and Prevention (CDC) website has not yet released the full addenda information, and the information below may be adjusted when the official guidance is released.

Discussion

The codes and descriptions were released with the CMS’ update of the Medicare-Severity Diagnosis Related Grouping (MS-DRG) software update, which is effective January 1, 2021. As mentioned, the official information from the CDC has yet to be published, so the diagnosis codes may change slightly. The coding guidelines have not yet been published, but are expected to be released soon. The ICD-10-PCS codes are related to the administration of COVID-19 vaccines and monoclonal antibody treatments.

ICD-10-CM Codes

6 New Codes Effective January 1, 2021
  • Z86.16 Personal history of COVID-19
  • J12.82 Pneumonia due to coronavirus disease 2019
  • M35.81 Multisystem inflammatory syndrome
  • M35.89 Other specified systemic involvement of connective tissue
  • Z11.52 Encounter for screening for COVID-19
  • Z20.822 Contact with and (suspected) exposure to COVID-19

ICD-10-PCS

21 New Codes Effective January 1, 2021
  • XW013H6 Introduction of other new technology monoclonal antibody into subcutaneous tissue, percutaneous approach, new technology group 6
  • XW013K6 Introduction of leronlimab monoclonal antibody into subcutaneous tissue, percutaneous approach, new technology group 6
  • XW013S6 Introduction of COVID-19 vaccine dose 1 into subcutaneous tissue, percutaneous approach, new technology group 6
  • XW013T6 Introduction of COVID-19 vaccine dose 2 into subcutaneous tissue, percutaneous approach, new technology group 6
  • XW013U6 Introduction of COVID-19 vaccine into subcutaneous tissue, percutaneous approach, new technology group 6
  • XW023S6 Introduction of COVID-19 vaccine dose 1 into muscle, percutaneous approach, new technology group 6
  • XW023T6 Introduction of COVID-19 vaccine dose 2 into muscle, percutaneous approach, new technology group 6
  • XW023U6 Introduction of COVID-19 vaccine into muscle, percutaneous approach, new technology group 6
  • XW033E6 Introduction of etesevimab monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
  • XW033F6 Introduction of bamlanivimab monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
  • XW033G6 Introduction of REGN-COV2 monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
  • XW033H6 Introduction of other new technology monoclonal antibody into peripheral vein, percutaneous approach, new technology group 6
  • XW033L6 Introduction of CD24Fc immunomodulator into peripheral vein, percutaneous approach, new technology group 6
  • XW043E6 Introduction of etesevimab monoclonal antibody into central vein, percutaneous approach, new technology group 6
  • XW043F6 Introduction of bamlanivimab monoclonal antibody into central vein, percutaneous approach, new technology group 6
  • XW043G6 Introduction of REGN-COV2 monoclonal antibody into central vein, percutaneous approach, new technology group 6
  • XW043H6 Introduction of other new technology monoclonal antibody into central vein, percutaneous approach, new technology group 6
  • XW043L6 Introduction of CD24Fc immunomodulator into central vein, percutaneous approach, new technology group 6
  • XW07M6 Introduction of baricitinib into lower GI, via natural or artificial opening, new technology group 6
  • XW0DXM6 Introduction of baricitinib into mouth and pharynx, external approach, new technology group 6
  • XW0G7M6 Introduction of baricitinib into upper GI, via natural or artificial opening, new technology group 6

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Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).