RIVANNA, developer of AI-enabled clinical decision-support solutions, announced that the Centers for Medicare & Medicaid Services (CMS) has established ICD-10-PCS code XEZU3HC, effective for inpatient discharges beginning October 1, 2026. The code identifies computer-aided intraprocedural navigation in the spinal canal using ultrasound imaging with continuous needle tracking via a percutaneous approach during neuraxial anesthesia.
Before XEZU3HC, use of diagnostic ultrasound navigation during neuraxial anesthesia was not separately reportable in inpatient hospital coding. Facilities could report the underlying neuraxial anesthesia under existing codes, but the navigation itself left no trace in the record. The new code changes what that record can show: a standardized way to identify coded use and track adoption, and, when linked with clinical and operational data, a basis for evaluating outcomes.
Unintended dural puncture occurs in 0.5 per cent to 1.5 per cent of labor epidural placements (Van de Velde 2008; Choi 2003), and the United States has no dedicated mandatory national reporting system for it. The consequences are not always brief: in a prospective multicenter cohort study that enrolled 90 patients with accidental dural puncture and 180 matched controls, 58 per cent of those who experienced accidental dural puncture still had persistent headache at 18 months, compared with 17 per cent of controls (Niraj 2021).
Accuro 3S brings ultrasound guidance into the placement itself. It is the first FDA-cleared, AI-enabled, real-time ultrasound guidance system purpose-built for neuraxial anesthesia. The system combines automated anatomical guidance through SpineNav-AI, midline needle access through the patented Dual-Array probe's central aperture, and real-time needle-tip tracking through SafeTrack. CMS recognized the technology as procedurally distinct. Beginning October 1, XEZU3HC makes this form of guidance identifiable in inpatient data.
"Accuro 3S was developed to bring real-time guidance to neuraxial procedures," said Will Mauldin, PhD, Co-founder and CEO of RIVANNA. "With XEZU3HC, that procedural shift will no longer be invisible in inpatient data. The code does not prove benefit; it gives hospitals a standardized way to identify use and, when linked with clinical data, evaluate outcomes."
