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September 2, 2021

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – October 2021 Update

Below is a summary of the changes for the October update to the 2021 MPFSDB. Unless otherwise stated, these changes are effective for dates of service on and after January 1, 2021.

The following HCPCS code has a change to the Bilateral Surgery Indicator. This change is effective for dates of service January 1, 2021, and after.

Code

Action

31591

Bilateral Surgery = 1

The following HCPCS codes have changes to the Diagnostic Imaging Family Indicator. These changes are effective for dates of service July 1, 2021, and after.

Code

Modifier

Action

0648T

 

Diagnostic Imaging Family Indicator = 88

0648T

TC

Diagnostic Imaging Family Indicator = 88

0648T

26

Diagnostic Imaging Family Indicator = 88

There is a revision to the short descriptor for the following HCPCS codes:

Code

Descriptor

M0243

Casirivi and imdevi inj

M0244

Casirivi and imdevi inj hm

The following are HCPCS codes from the July 2021 HCPCS file update. For more information on the new codes, please reference:  https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS-Quarterly-UpdateExternal website.

Code

Action

Effective Date

M0201

Procedure Status = X; payment policy indicators do not apply.

June 08, 2021

M0247

Procedure Status = X; payment policy indicators do not apply.

May 26, 2021

M0248

Procedure Status = X; payment policy indicators do not apply.

May 26, 2021

Q0247

Procedure Status = X; payment policy indicators do not apply.

May 26, 2021

The following new HCPCS code is from the October 2021 HCPCS file update. It is effective for dates of service June 3, 2021, and after.

Code

Action

Q0244

Procedure Status = X; payment policy indicators do not apply.

The following new HCPCS codes are from the October 2021 HCPCS file update. They are effective for dates of service June 24, 2021, and after.

Code

Action

M0249

Procedure Status = X; payment policy indicators do not apply.

M0250

Procedure Status = X; payment policy indicators do not apply.

Q0249

Procedure Status = X; payment policy indicators do not apply.

The following new HCPCS codes are from the October 2021 HCPCS file update. They are effective for dates of service October 1, 2021, and after.

Code

Action

J0699

Procedure Status = E; payment policy indicators do not apply.

J0741

Procedure Status = E; payment policy indicators do not apply.

J1305

Procedure Status = E; payment policy indicators do not apply.

J1426

Procedure Status = E; payment policy indicators do not apply.

J1445

Procedure Status = E; payment policy indicators do not apply.

J1448

Procedure Status = E; payment policy indicators do not apply.

J2406

Procedure Status = E; payment policy indicators do not apply.

J9247

Procedure Status = E; payment policy indicators do not apply.

Q2054

Procedure Status = X; payment policy indicators do not apply.

Q4251

Procedure Status = E; payment policy indicators do not apply.

Q4252

Procedure Status = E; payment policy indicators do not apply.

Q4253

Procedure Status = E; payment policy indicators do not apply.

The following HCPCS codes are deleted from the MPFS effective for dates of service October 1, 2021, and after.

Code

Action

J0693

Procedure Status = I

Q4228

Procedure Status = I

Q4236

Procedure Status = I

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