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CMS Creates New ICD-10 Code for AI-Guided Neuraxial Procedures

Effective October 1, 2026, the Centers for Medicare & Medicaid Services has introduced ICD-10-PCS code XEZU3HC. This designation marks the first national inpatient category for computer-aided neuraxial navigation, finally allowing hospitals to track real-time ultrasound guidance during spinal procedures within their official clinical and operational records.

CMS Creates New ICD-10 Code for AI-Guided Neuraxial Procedures
Photo: Bio & News

Before this update, ultrasound-assisted neuraxial anesthesia lacked a dedicated identifier, leaving the use of navigation tools invisible in hospital datasets. By placing XEZU3HC under the "New Technology" section, CMS provides a standardized framework to monitor the adoption of systems like RIVANNA’s Accuro 3S, which utilizes SpineNav-AI and SafeTrack technology to assist with needle placement. While the code does not guarantee separate reimbursement, it creates the essential data infrastructure required to evaluate long-term clinical outcomes and potential economic impacts.

Accurate tracking is significant given the risks associated with manual neuraxial placement. Research indicates that unintended dural punctures occur in up to 1.5% of labor epidural cases, often resulting in persistent headaches for patients. With the new coding, providers can now link procedural data to patient outcomes, moving away from reliance on tactile palpation alone. RIVANNA plans to integrate this code into its outcomes framework by the fourth quarter of 2026 to help institutions measure the value of AI-enabled navigation in real-world settings.

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