ICD-10 Coding

ICD-10, or the International Classification of Diseases, 10th Revision, is the globally recognized system used to code diagnoses and inpatient hospital procedures in the U.S. healthcare system. Managed by the Centers for Medicare & Medicaid Services (CMS) and the CDC, ICD-10 has two key parts:

• ICD-10-CM for diagnoses
• ICD-10-PCS for inpatient procedures (used in MS-DRG billing)

In the context of medical device commercialization, ICD-10-PCS procedure codes are especially critical for products used in the hospital inpatient setting. Without a procedure code, hospitals may not be able to bill for your innovation—delaying access, reimbursement, and adoption.

At Lonsberry Consulting™, we help MedTech innovators strategically obtain and optimize ICD-10-PCS codes as part of a comprehensive PRECODE™ strategy, ensuring your technology is not only clinically sound but economically viable.

✅ Enables hospitals to bill CMS and private payers for inpatient use of your device
✅ Triggers assignment to a Medicare Severity Diagnosis-Related Group (MS-DRG)
✅ Supports applications for NTAP or new technology MS-DRG reassignment
✅ Provides structured utilization data for payers and health technology assessments (HTAs)
✅ Enhances coverage and adoption pathways by aligning with clinical coding norms

With deep experience in DRG mechanics and ICD-10 code development, Lonsberry Consulting™ helps you:

• Determine whether a new ICD-10-PCS code is needed for your device
• Prepare and submit ICD-10 proposals to CMS’s Coordination and Maintenance Committee
• Develop coding guidance and use-case documentation for hospitals
• Align ICD-10 strategy with NTAP, pricing, and DRG reassignment opportunities
• Model reimbursement impact and identify MS-DRG gaps

Within the PRECODE™ framework, ICD-10 coding is not just a technical detail—it’s a core driver of inpatient reimbursement. We help you think about ICD-10 before your clinical trial starts, designing your surgical technique and procedural claims around billable, reimbursable pathways.

• Inpatient devices requiring new or modified procedural codes
• Technologies applying for NTAP or DRG reassignment
• Companies targeting CMS and hospital formulary adoption
• MedTech innovators seeking to align regulatory and economic strategy

Reimbursement starts with the right code. Without ICD-10-PCS alignment, even the most innovative product may be unbillable or underpaid. ICD-10 isn’t just a compliance box—it’s a strategic access tool that supports your long-term success in the inpatient space.

Let us help you code for what your innovation is truly worth.