New HCPCS codes effective from 1st April 2024

CMS published its HCPCS Quarterly Update in March, which heralded the sum of 94 HCPCS Level II code additions, discontinuations, and definition revisions. The changes became effective April 1.

62 added codes
21 discontinued codes
11 revised codes

Below are the Newly added HCPCS codes effective 1st April 2024

A2026 Restrata minimatrix, 5 mg
A4271 Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per month
A4438 Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
A4564 Pessary, disposable, any type
A4593 Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller
A4594 Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each
A9293 Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)
C9166 Injection, secukinumab, intravenous, 1 mg
C9167 Injection, adamts13, recombinant-krhn, 10 iu
C9168 Injection, mirikizumab-mrkz, 1 mg
E0152 Walker, battery powered, wheeled, folding, adjustable or fixed height
E0468 Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions
E0736 Transcutaneous tibial nerve stimulator
E0738 Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories
E0739  Rehab system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors
E2104 Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge
E2298 Complex rehabilitative power wheelchair accessory, power seat elevation system, any type
G0138 Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga
H0051 Traditional healing service
J0177 Injection, aflibercept hd, 1 mg
J0209 Injection, sodium thiosulfate (hope), 100 mg
J0577  Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
J0578 Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy
J0589 Injection, daxibotulinumtoxina-lanm, 1 unit
J0650  Injection, levothyroxine sodium, not otherwise specified, 10 mcg
J0651 Injection, levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650, 10 mcg
J0652 Injection, levothyroxine sodium (hikma) not therapeutically equivalent to j0650, 10 mcg
J1010  Injection, methylprednisolone acetate, 1 mg
J1202 Miglustat, oral, 65 mg
J1203  Injection, cipaglucosidase alfa-atga, 5 mg
J1323 Injection, elranatamab-bcmm, 1 mg
J1434 Injection, fosaprepitant (focinvez), 1 mg
J2277  Injection, motixafortide, 0.25 mg
J2782 Injection, avacincaptad pegol, 0.1 mg
J2801 Injection, risperidone (rykindo), 0.5 mg
J2919 Injection, methylprednisolone sodium succinate, 5 mg
J3055 Injection, talquetamab-tgvs, 0.25 mg
J3424 Injection, hydroxocobalamin, intravenous, 25 mg
J7165 Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
J7354 Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
J9073 Injection, cyclophosphamide (ingenus), 5 mg
J9074 Injection, cyclophosphamide (sandoz), 5 mg
J9075 Injection, cyclophosphamide, not otherwise specified, 5 mg
J9248 Injection, melphalan (hepzato), 1 mg
J9249 Injection, melphalan (apotex), 1 mg
J9376 Injection, pozelimab-bbfg, 1 mg
K1037 Docking station for use with oral device/appliance used to reduce upper airway collapsibility
L1320 Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
L5783 Addition to lower extremity, user adjustable, mechanical, residual limb volume management system
L5841 Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control
Q4305 American amnion ac tri-layer, per square centimeter
Q4306 American amnion ac, per square centimeter
Q4307 American amnion, per square centimeter
Q4308 Sanopellis, per square centimeter
Q4309 Via matrix, per square centimeter
Q4310 Procenta, per 100 mg
Q5133 Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg
Q5134  Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg
S4988 Penile contracture device, manual, greater than 3 lbs traction force
S9002 Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device

Discontinued Codes effective 1st April 2024

0354U Human papilloma virus (HPV) by quantitative polymerase chain reaction (qPCR)
0416U Detection of DNA of 20 organisms in urine

C9159 Injection, prothrombin complex concentrate (human), balfaxar, per i.u. of factor ix activity
C9160 Injection, daxibotulinumtoxina-lanm, 1 unit
C9161  Injection, aflibercept hd, 1 mg
C9162  Injection, avacincaptad pegol, 0.1 mg
C9163 Injection, talquetamab-tgvs, 0.25 mg
C9164 Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
C9165 Injection, elranatamab-bcmm, 1 mg
E2300 Wheelchair accessory, power seat elevation system, any type
J0576  Injection, buprenorphine extended-release (brixadi), 1 mg
J1020  Injection, methylprednisolone acetate, 20 mg
J1030  Injection, methylprednisolone acetate, 40 mg
J1040  Injection, methylprednisolone acetate, 80 mg
J1840  Injection, kanamycin sulfate, up to 500 mg
J1850  Injection, kanamycin sulfate, up to 75 mg
J2920  Injection, methylprednisolone sodium succinate, up to 40 mg
J2930  Injection, methylprednisolone sodium succinate, up to 125 mg
J9070 Cyclophosphamide, 100 mg
J9250 Methotrexate sodium, 5 mg
Q4244 Procenta, per 200 mg

Revised codes

A4561 Pessary, reusable, rubber, any type
A4562 Pessary, reusable, non rubber, any type
E2001 Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system
J0208 Injection, sodium thiosulfate (pedmark), 100 mg
J0612 Injection, calcium gluconate, not otherwise specified, 10 mg
J0613 Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg
J3380 Injection, vedolizumab, intravenous, 1 mg
J3425 Injection, hydroxocobalamin, intramuscular, 10 mcg
J7516 Injection, cyclosporine, 250 mg
J9029 Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose
J9255 Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg
J9260 Injection, methotrexate sodium, 50 mg

Leave a Reply