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Medical Coding News Archives

Quarterly HCPCS Level II Update Has Varying Effective Dates

 
April 20, 2012:

Karen Kachur, RN, CPC, Clinical/Technical Editor

The quarterly update to HCPCS Level II codes includes several additions, revisions, and deletions. It is important to note the effective date of each change, as they do vary.

The following non-Medicare HCPCS Level II codes have been added to the HCPCS file for this update and were effective April 1, 2012.

S0353 Treatment planning and care coordination management for cancer initial treatment
S0354 Treatment planning and care coordination management for cancer established patient with a change of regimen
S0596 Phakic intraocular lens for correction of refractive error
S3721 Prostate cancer antigen 3 (pca3) testing
S8930 Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient

Also effective April 1, 2012, the following non-Medicare HCPCS Level II codes have been deleted from the file:

S3711 Circulating tumor cell test
S3713 KRAS mutation analysis testing
S3818 Complete gene sequence analysis; BRCA1 gene
S3819 Complete gene sequence analysis; BRCA2 gene
S3820 Complete BRCA1 and BRCA2 gene sequence analysis for susceptibility to breast and ovarian cancer
S3822 Single mutation analysis (in individual with a known BRCA1 or BRCA2 mutation in the family) for susceptibility to breast and ovarian cancer
S3823 Three-mutation BRCA1 and BRCA2 analysis for susceptibility to breast and ovarian cancer in Ashkenazi individuals
S3828 Complete gene sequence analysis; MLH1 gene
S3829 Complete gene sequence analysis; MSH2 gene
S3830 Complete MLH1 and MSH2 gene sequence analysis for hereditary nonpolyposis colorectal cancer (HNPCC) genetic testing
S3831 Single-mutation analysis (in individual with a known MLH1 and MSH2 mutation in the family) for hereditary nonpolyposis colorectal cancer (HNPCC) genetic testing
S3835 Complete gene sequence analysis for cystic fibrosis genetic testing
S3837 Complete gene sequence analysis for hemochromatosis genetic testing
S3843 DNA analysis of the F5 gene for susceptibility to factor V Leiden thrombophilia
S3847 Genetic testing for Tay-Sachs disease
S3848 Genetic testing for Gaucher disease
S3851 Genetic testing for Canavan disease
S3860 Genetic testing, comprehensive cardiac ion channel analysis, for variants in 5 major cardiac channel genes for individuals with high index of suspicion for familial long QT syndrome (LQTS) or related syndromes
S3862 Genetic testing, family-specific ion channel analysis, for blood-relatives of individuals (index case) who have previously tested positive for a genetic variant of a cardiac ion channel syndrome using either one of the above test configurations or confirmed results from another laboratory
S8049 Intraoperative radiation therapy (single administration)

The following codes, effective April 1, 2012, are used by outpatient prospective payment system hospitals:

C9288. Injection, Centruroides (scorpion) immune f(ab)2 (equine), 1 vial
C9289 Injection, asparaginase Erwinia chrysanthemi, 1,000 international units (I.U.)
C9290 Injection, bupivacaine liposome, 1 mg
C9291 Injection, aflibercept, 2 mg vial
C9733 Nonophthalmic fluorescent vascular angiography

The following codes were added with a retroactive effective date of January 1, 2012:

G8675 Most recent systolic blood pressure >= 140 mm hg
G8676 Most recent diastolic blood pressure >= 90 mm hg
G8677 Most recent systolic blood pressure < 130 mm hg
G8678 Most recent systolic blood pressure 130 to 139 mm hg
G8679 Most recent diastolic blood pressure < 80 mm hg
G8680 Most recent diastolic blood pressure 80 - 89 mm hg

Added with a retroactive effective date of July 1, 2011, the following are for use in the three-year Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration:

G9148 National Committee for Quality Assurance-Level 1 medical home
G9149 National Committee for Quality Assurance-Level 2 medical home
G9150 National Committee for Quality Assurance-Level 3 medical home
G9151 MAPCP Demonstration-State Provided Services
G9152 MAPCP Demonstration-Community Health Teams
G9153 MAPCP Demonstration-Physician Incentive Pool

Other changes include the deletion of the following HCPCS Level II modifiers from the file:

V8 Infection present
V9 Infection not present

Effective July 1, 2012, codes J1680 and J9001 will be revised and the following added:

Q2034 Influenza virus vaccine, split virus, for intramuscular use (agriflu)
Q2045 Injection, human fibrinogen concentrate, 1 mg
Q2046 Injection, aflibercept, 1 mg
Q2047 Injection, peginesatide, 0.1 mg (for esrd on dialysis)
Q2048 Injection, doxorubicin hydrochloride, liposomal, doxil, 10 mg
Q2049 Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg
S1090 Mometasone furoate sinus implant, 370 micrograms

 

 
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