Limited Coverage - ICD-10-PCS Code Edits

The following 50 ICD-10-PCS codes are intended for limited coverage. For certain procedures whose medical complexity and serious nature incur extraordinary associated costs, Medicare limits coverage to a portion of the cost.


ICD-10-PCS CodeDescriptionSectionBody SystemOperation
02HA0QZInsertion of Implantable Heart Assist System into Heart, Open ApproachMedical and SurgicalHeart and Great VesselsInsertion
02WA0JZRevision of Synthetic Substitute in Heart, Open ApproachMedical and SurgicalHeart and Great VesselsRevision
02WA0QZRevision of Implantable Heart Assist System in Heart, Open ApproachMedical and SurgicalHeart and Great VesselsRevision
02YA0Z0Transplantation of Heart, Allogeneic, Open ApproachMedical and SurgicalHeart and Great VesselsTransplantation
02YA0Z1Transplantation of Heart, Syngeneic, Open ApproachMedical and SurgicalHeart and Great VesselsTransplantation
02YA0Z2Transplantation of Heart, Zooplastic, Open ApproachMedical and SurgicalHeart and Great VesselsTransplantation
0BYC0Z0Transplantation of Right Upper Lung Lobe, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYC0Z1Transplantation of Right Upper Lung Lobe, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYC0Z2Transplantation of Right Upper Lung Lobe, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYD0Z0Transplantation of Right Middle Lung Lobe, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYD0Z1Transplantation of Right Middle Lung Lobe, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYD0Z2Transplantation of Right Middle Lung Lobe, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYF0Z0Transplantation of Right Lower Lung Lobe, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYF0Z1Transplantation of Right Lower Lung Lobe, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYF0Z2Transplantation of Right Lower Lung Lobe, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYG0Z0Transplantation of Left Upper Lung Lobe, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYG0Z1Transplantation of Left Upper Lung Lobe, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYG0Z2Transplantation of Left Upper Lung Lobe, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYH0Z0Transplantation of Lung Lingula, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYH0Z1Transplantation of Lung Lingula, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYH0Z2Transplantation of Lung Lingula, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYJ0Z0Transplantation of Left Lower Lung Lobe, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYJ0Z1Transplantation of Left Lower Lung Lobe, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYJ0Z2Transplantation of Left Lower Lung Lobe, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYK0Z0Transplantation of Right Lung, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYK0Z1Transplantation of Right Lung, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYK0Z2Transplantation of Right Lung, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYL0Z0Transplantation of Left Lung, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYL0Z1Transplantation of Left Lung, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYL0Z2Transplantation of Left Lung, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYM0Z0Transplantation of Bilateral Lungs, Allogeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYM0Z1Transplantation of Bilateral Lungs, Syngeneic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0BYM0Z2Transplantation of Bilateral Lungs, Zooplastic, Open ApproachMedical and SurgicalRespiratory SystemTransplantation
0DY80Z0Transplantation of Small Intestine, Allogeneic, Open ApproachMedical and SurgicalGastrointestinal SystemTransplantation
0DY80Z1Transplantation of Small Intestine, Syngeneic, Open ApproachMedical and SurgicalGastrointestinal SystemTransplantation
0DY80Z2Transplantation of Small Intestine, Zooplastic, Open ApproachMedical and SurgicalGastrointestinal SystemTransplantation
0DYE0Z0Transplantation of Large Intestine, Allogeneic, Open ApproachMedical and SurgicalGastrointestinal SystemTransplantation
0DYE0Z1Transplantation of Large Intestine, Syngeneic, Open ApproachMedical and SurgicalGastrointestinal SystemTransplantation
0DYE0Z2Transplantation of Large Intestine, Zooplastic, Open ApproachMedical and SurgicalGastrointestinal SystemTransplantation
0FY00Z0Transplantation of Liver, Allogeneic, Open ApproachMedical and SurgicalHepatobiliary System and PancreasTransplantation
0FY00Z1Transplantation of Liver, Syngeneic, Open ApproachMedical and SurgicalHepatobiliary System and PancreasTransplantation
0FY00Z2Transplantation of Liver, Zooplastic, Open ApproachMedical and SurgicalHepatobiliary System and PancreasTransplantation
0FYG0Z0Transplantation of Pancreas, Allogeneic, Open ApproachMedical and SurgicalHepatobiliary System and PancreasTransplantation
0FYG0Z1Transplantation of Pancreas, Syngeneic, Open ApproachMedical and SurgicalHepatobiliary System and PancreasTransplantation
0TY00Z0Transplantation of Right Kidney, Allogeneic, Open ApproachMedical and SurgicalUrinary SystemTransplantation
0TY00Z1Transplantation of Right Kidney, Syngeneic, Open ApproachMedical and SurgicalUrinary SystemTransplantation
0TY00Z2Transplantation of Right Kidney, Zooplastic, Open ApproachMedical and SurgicalUrinary SystemTransplantation
0TY10Z0Transplantation of Left Kidney, Allogeneic, Open ApproachMedical and SurgicalUrinary SystemTransplantation
0TY10Z1Transplantation of Left Kidney, Syngeneic, Open ApproachMedical and SurgicalUrinary SystemTransplantation
0TY10Z2Transplantation of Left Kidney, Zooplastic, Open ApproachMedical and SurgicalUrinary SystemTransplantation