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Updated 2025 ICD-10-PCS Procedure Codes Effective April 1, 2025

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective for dates of service on or after April 1, 2025, the 2025 International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) surgical procedure codes will be updated.

The ICD-10-PCS procedure codes are inpatient hospital procedure codes and must be submitted, as applicable, only on inpatient hospital claims.

Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) Manual and the Centers for Medicare and Medicaid (CMS) Healthcare Common Procedure Coding System (HCPCS) Manual.

The following ICD-10-PCS inpatient hospital surgical procedure code changes are for inpatient hospital providers. Providers should refer to the appropriate copyright holder’s code listing for descriptions of the new, discontinued, and revised procedure codes indicated below. All discontinued procedure codes will not be reimbursed for dates of service on or after April 1, 2025.

Note: These procedure codes are surgical codes used to assign the proper diagnosis-related group (DRG) for an inpatient hospital stay and are processed as informational only.

New PCS Surgical Procedure Codes
0B118D60CYS0Z00CYS0Z10DX80Z70DX84Z70TT00Z00TT00Z1
0TT00Z20TT10Z00TT10Z10TT10Z20U7C7DJ10D10ZZ3E0U0GC
D228DZZX2KA30AX2U93YAXNS40GAXNS43GAXNS50GAXNS53GA
XNS60GAXNS63GAXNS70GAXNS73GAXNS80GAXNS83GAXNS90GA
XNS93GAXNSA0GAXNSA3GAXNSB0GAXNSB3GAXNSC0GAXNSC3GA
XNSD0GAXNSD3GAXNSE0GAXNSE3GAXNSF0GAXNSF3GAXNSG0GA
XNSG3GAXNSH0GAXNSH3GAXW033MAXW033NAXW043MAXW043NA
XXE5X5A      
Discontinued PCS Surgical Procedure Codes
0SG604Z0SG607Z0SG60JZ0SG60KZ0SG634Z0SG637Z0SG63JZ
0SG63KZ0SG644Z0SG647Z0SG64JZ0SG64KZ  
Revised PCS Surgical Procedure Codes
XW133G8XW143G8     

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.