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Limited Coverage - ICD-10-PCS Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding claims data. The following 49 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.

  • Revision of Heart and Great Vessels

    • 02WA3QZ - Revision of Implantable Heart Assist System in Heart, Percutaneous Approach

    • 02WA4QZ - Revision of Implantable Heart Assist System in Heart, Percutaneous Endoscopic Approach

  • Transplantation of Heart and Great Vessels

    • 02YA0Z0 - Transplantation of Heart, Allogeneic, Open Approach

    • 02YA0Z1 - Transplantation of Heart, Syngeneic, Open Approach

    • 02YA0Z2 - Transplantation of Heart, Zooplastic, Open Approach

  • Transplantation of Respiratory System

    • 0BYC0Z0 - Transplantation of Right Upper Lung Lobe, Allogeneic, Open Approach

    • 0BYC0Z1 - Transplantation of Right Upper Lung Lobe, Syngeneic, Open Approach

    • 0BYC0Z2 - Transplantation of Right Upper Lung Lobe, Zooplastic, Open Approach

    • 0BYD0Z0 - Transplantation of Right Middle Lung Lobe, Allogeneic, Open Approach

    • 0BYD0Z1 - Transplantation of Right Middle Lung Lobe, Syngeneic, Open Approach

    • 0BYD0Z2 - Transplantation of Right Middle Lung Lobe, Zooplastic, Open Approach

    • 0BYF0Z0 - Transplantation of Right Lower Lung Lobe, Allogeneic, Open Approach

    • 0BYF0Z1 - Transplantation of Right Lower Lung Lobe, Syngeneic, Open Approach

    • 0BYF0Z2 - Transplantation of Right Lower Lung Lobe, Zooplastic, Open Approach

    • 0BYG0Z0 - Transplantation of Left Upper Lung Lobe, Allogeneic, Open Approach

    • 0BYG0Z1 - Transplantation of Left Upper Lung Lobe, Syngeneic, Open Approach

    • 0BYG0Z2 - Transplantation of Left Upper Lung Lobe, Zooplastic, Open Approach

    • 0BYH0Z0 - Transplantation of Lung Lingula, Allogeneic, Open Approach

    • 0BYH0Z1 - Transplantation of Lung Lingula, Syngeneic, Open Approach

    • 0BYH0Z2 - Transplantation of Lung Lingula, Zooplastic, Open Approach

    • 0BYJ0Z0 - Transplantation of Left Lower Lung Lobe, Allogeneic, Open Approach

    • 0BYJ0Z1 - Transplantation of Left Lower Lung Lobe, Syngeneic, Open Approach

    • 0BYJ0Z2 - Transplantation of Left Lower Lung Lobe, Zooplastic, Open Approach

    • 0BYK0Z0 - Transplantation of Right Lung, Allogeneic, Open Approach

    • 0BYK0Z1 - Transplantation of Right Lung, Syngeneic, Open Approach

    • 0BYK0Z2 - Transplantation of Right Lung, Zooplastic, Open Approach

    • 0BYL0Z0 - Transplantation of Left Lung, Allogeneic, Open Approach

    • 0BYL0Z1 - Transplantation of Left Lung, Syngeneic, Open Approach

    • 0BYL0Z2 - Transplantation of Left Lung, Zooplastic, Open Approach

    • 0BYM0Z0 - Transplantation of Bilateral Lungs, Allogeneic, Open Approach

    • 0BYM0Z1 - Transplantation of Bilateral Lungs, Syngeneic, Open Approach

    • 0BYM0Z2 - Transplantation of Bilateral Lungs, Zooplastic, Open Approach

  • Transplantation of Gastrointestinal System

    • 0DY80Z0 - Transplantation of Small Intestine, Allogeneic, Open Approach

    • 0DY80Z1 - Transplantation of Small Intestine, Syngeneic, Open Approach

    • 0DY80Z2 - Transplantation of Small Intestine, Zooplastic, Open Approach

    • 0DYE0Z0 - Transplantation of Large Intestine, Allogeneic, Open Approach

    • 0DYE0Z1 - Transplantation of Large Intestine, Syngeneic, Open Approach

    • 0DYE0Z2 - Transplantation of Large Intestine, Zooplastic, Open Approach

  • Transplantation of Hepatobiliary System and Pancreas

    • 0FY00Z0 - Transplantation of Liver, Allogeneic, Open Approach

    • 0FY00Z1 - Transplantation of Liver, Syngeneic, Open Approach

    • 0FY00Z2 - Transplantation of Liver, Zooplastic, Open Approach

    • 0FYG0Z0 - Transplantation of Pancreas, Allogeneic, Open Approach

    • 0FYG0Z1 - Transplantation of Pancreas, Syngeneic, Open Approach

  • Transplantation of Urinary System

    • 0TY00Z0 - Transplantation of Right Kidney, Allogeneic, Open Approach

    • 0TY00Z1 - Transplantation of Right Kidney, Syngeneic, Open Approach

    • 0TY00Z2 - Transplantation of Right Kidney, Zooplastic, Open Approach

    • 0TY10Z0 - Transplantation of Left Kidney, Allogeneic, Open Approach

    • 0TY10Z1 - Transplantation of Left Kidney, Syngeneic, Open Approach

    • 0TY10Z2 - Transplantation of Left Kidney, Zooplastic, Open Approach