This segment of “In the kNOW” discusses laser interstitial thermal therapy (LITT). What is it? Why the big change in how it is coded in ICD-10-PCS for FY2023?
Laser interstitial thermal therapy is a minimally invasive treatment for tumors. It also has applications for treating regions of the brain that are responsible for seizures. The process involves insertion of a catheter, through which, a laser is used. The treatment site is identified using real-time MRI, thus allowing the laser to focus on a very specific area. The heat from the laser then destroys the targeted tissue.
Source: https://neuronewsinternational.com/new-laser-interstitial-thermal-therapy-for-brain-lesions-data-presented-at-aans-2016/
In ICD-10-PCS in 2022, codes for LITT were located in the Radiation Therapy Section and began with character D. For FY2023, the laser interstitial thermal therapy codes are being moved into the Medical and Surgical section and will begin with the character 0. Why? That’s a good question, and here is the answer. The Radiation Therapy section of ICD-10-PCS is designed to capture very specific types of radiation treatment including ionizing radiation, beam radiation, brachytherapy, and stereotactic radiosurgery. The LITT procedure, however, is performed using heat. Therefore, it truly does not belong in Radiation Therapy, and with the move to Med/Surg will be reported as a Destruction procedure. We can see that Destruction is the appropriate root operation here when we review the definition of Destruction which is:
Physical eradication of all or a portion of a body part by
the direct use of energy, force, or a destructive agent
Since heat is a form of energy, Destruction is definitely the correct root operation.
As such, this procedure will be found in the ICD-10-PCS Index under Destruction, LITT, or laser interstitial thermal therapy.
One additional item of note is that there have been many changes to the body part values which are appropriate to use for this procedure. Several deletions were made including the body parts mediastinum and peripheral nerve. Also, many additions were made including the body parts of ileocecal valve, and aortic body. In fact, 27 additions were in the respiratory system, 39 in the hepatobiliary and pancreas system, 66 in the endocrine system, 6 for the breast, and 3 for the prostate.
Now you are In the kNOW!!
About the Author
Dianna Foley, RHIA, CCS, CHPS, CDIP is
OHIMA's Education Coordinator. Dianna has been an HIM
professional for over 20 years. She progressed through the ranks of coder,
department supervisor, and department director, to her current role as a
coding consultant. She previously served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati and holds RHIA, CHPS, CDIP and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and is a presenter on coding topics at the national, state, and regional levels. Dianna mentors new AHIMA members and also provides monthly educational lectures to coders and clinical documentation specialists.
