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March 14, 2023

April 2023 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes and Modifiers

The following information is based on the April 2023 Healthcare Common Procedure Coding System (HCPCS) file. There are several updates that will be effective April 1, 2023. Please keep in mind that the appearance of a HCPCS code is not an indication of coverage by the DME MAC.

This following list contains added HCPCS codes that will be effective April 1, 2023.

HCPCS DESCRIPTION
A4341 Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
A4342 Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each
A4560 Neuromuscular electrical stimulator (nmes), disposable, replacement only
A6590 External urinary catheters; disposable, with wicking material, for use with suction pump, per month
A6591 External urinary catheter; non-disposable, for use with suction pump, per month
A7049 Expiratory positive airway pressure intranasal resistance valve
E0677 Non-pneumatic sequential compression garment, trunk
E0711 Upper extremity medical tubing/lines enclosure or covering device, restricts elbow range of motion
E1905 Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software
J0208 Injection, sodium thiosulfate, 100 mg
J0218 Injection, olipudase alfa-rpcp, 1 mg
J0612 Injection, calcium gluconate (fresenius kabi), per 10 mg
J0613 Injection, calcium gluconate (wg critical care), per 10 mg
J1411 Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
J1449 Injection, eflapegrastim-xnst, 0.1 mg
J1747 Injection, spesolimab-sbzo, 1 mg
J2403 Chloroprocaine hcl ophthalmic, 3% gel, 1 mg
J9196 Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg
J9294 Injection, pemetrexed (hospira) not therapeutically equivalent to j9305, 10 mg
J9296 Injection, pemetrexed (accord) not therapeutically equivalent to j9305, 10 mg
J9297 Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg

The following HCPCS codes have description/verbiage changes that will be effective April 1, 2023.

HCPCS DESCRIPTION
A4628 Oral and/or oropharyngeal suction catheter, each
J1954 Injection, leuprolide acetate for depot suspension (cipla), 7.5 mg
K1019 Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
Q5108 Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
Q5111 Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
Q5120 Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg

The following listing contains discontinued HCPCS codes, along with the cross-walked HCPCS codes (if applicable). Please note, not all discontinued HCPCS codes will have a cross-walked HCPCS code. 

HCPCS DISCONTINUE DATE CROSSWALK HCPCS CODE
J0610 03/31/2023 None
J0611 03/31/2023 None

The following modifiers will be effective April 1, 2023.

Modifier DESCRIPTION
JK One month supply or less of drug or biological
JL Three month supply of drug or biological

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