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March 27, 2018

Spring OPPS Update Released

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Medical Coding News Archives

HCPCS Code Update

May 16, 2013:

Nannette Orme, CPC, CCS-P, CPMA, CEMC, Clinical/Technical Editor

The latest update to HCPCS Level II codes includes various revisions, additions, and even two reinstatements. It is important for providers to incorporate the changes into their billing systems by the established effective dates to avoid claim denials.

During the fourth quarter of every year, the Centers for Medicare and Medicaid Services (CMS) releases a file containing all the HCPCS codes that will be effective as of January 1 of the following year. CMS also releases quarterly updates to the code set.

The following codes were new as of April 1, 2013:

  • C9130 Injection, immune globulin (Bivigam), 500 mg
  • C9297 Injection, omacetaxine mepesuccinate, 0.01 mg
  • C9298 Injection, ocriplasmin, 0.125 mg
  • C9734 Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with or without magnetic resonance (MR) guidance
  • C9735 Anoscopy; with directed submucosal injection(s), any substance

CMS also revised one code effective April 1, 2013:

  • Q0509 Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under Medicare Part A.

Additional changes effective July 1, 2013, include a new modifier related to dialysis:

  • JE Administered via dialysate
  • New codes that were added effective July1, 2013, include:

    • K0900 Customized durable medical equipment, other than wheelchair
    • Q0090 Levonorgestrel-releasing intrauterine contraceptive system (SKYLA), 13.5 mg
    • Q2033 Influenza vaccine, recombinant hemagglutinin antigens, for intramuscular use (Flu Blok)
    • Q2050 Injection, Doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg
    • Q2051 Injection, Zoledronic acid, not otherwise specified, 1 mg

    On occasion, CMS will reinstate a HCPCS code. The July 1, 2013, update reinstates two codes:

    • K0008 Custom manual wheelchair base
    • K0013 Custom motorized/power wheelchair base

    For the July quarterly update, CMS has also revised many of the HCPCS codes. The codes, with their new descriptions, are below:

    • J3487 Injection, zoledronic acid (Zometa), 1 mg
    • J3488 Injection, zoledronic acid (Reclast), 1 mg
    • J9002 Injection, doxorubicin hydrochloride, liposomal, Doxil, 10 mg
    • Q5001 Hospice or home health care provided in patient’s home/residence
    • Q5002 Hospice or home health care provided in assisted living facility
    • Q5009 Hospice or home health care provided in place not otherwise specified (NOS)


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