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November 28, 2016 - Revised 12.15.16

The 2017 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes

The 2017 Healthcare Common Procedure Coding System (HCPCS) File has been published. There are several additions, revisions, and discontinued HCPCS codes. The changes are effective January 1, 2017. Please keep in mind, the appearance of a HCPCS code is not an indication of coverage by the DME MAC.

The first listing contains the added HCPCS Codes that will take effect on January 01, 2017.

HCPCS DESCRIPTION
A4224 Supplies for maintenance of insulin infusion catheter, per week
A4225 Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
A4467 Belt, strap, sleeve, garment, or covering, any type
A4553 Non-disposable underpads, all sizes
A9285 Inversion/eversion correction device
A9286 Hygienic item or device, disposable or non-disposable, any type, each
J0570 Buprenorphine implant, 74.2 mg
J0883 Injection, argatroban, 1 mg (for non-esrd use)
J0884 Injection, argatroban, 1 mg (for esrd on dialysis)
J1130 Injection, diclofenac sodium, 0.5 mg
J1942 Injection, aripiprazole lauroxil, 1 mg
J2182 Injection, mepolizumab, 1 mg
J2786 Injection, reslizumab, 1 mg
J2840 Injection, sebelipase alfa, 1 mg
J8670 Rolapitant, oral, 1 mg
J9034 Injection, bendamustine hcl (bendeka), 1 mg
J9145 Injection, daratumumab, 10 mg
J9176 Injection, elotuzumab, 1 mg
J9205 Injection, irinotecan liposome, 1 mg
J9295 Injection, necitumumab, 1 mg
J9325 Injection, talimogene laherparepvec, per 1 million plaque forming units
J9352 Injection, trabectedin, 0.1 mg
L1851 Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
L1852 Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Q5102 Injection, infliximab, biosimilar, 10 mg

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The listing of HCPCS Codes with description/verbiage changes that will take effect January 01, 2017 is as follows:

HCPCS DESCRIPTION
A4221 Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)
B9002 Enteral nutrition infusion pump, any type
E0627 Seat lift mechanism, electric, any type
E0629 Seat lift mechanism, non-electric, any type
E0740 Non-implanted pelvic floor electrical stimulator, complete system
E0967 Manual wheelchair accessory, hand rim with projections, any type, replacement only, each
E0995 Wheelchair accessory, calf rest/pad, replacement only, each
E2206 Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each
E2220 Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each
E2221 Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each
E2222 Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each
E2224 Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each
J0573 Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine
J1745 Injection, infliximab, excludes biosimilar, 10 mg
J3357 Ustekinumab, for subcutaneous injection, 1 mg
J7340 Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml
J9033 Injection, bendamustine hcl (treanda), 1 mg
K0015 Detachable, non-adjustable height armrest, replacement only, each
K0019 Arm pad, replacement only, each
K0037 High mount flip-up footrest, replacement only, each
K0042 Standard size footplate, replacement only, each
K0043 Footrest, lower extension tube, replacement only, each
K0044 Footrest, upper hanger bracket, replacement only, each
K0045 Footrest, complete assembly, replacement only, each
K0046 Elevating legrest, lower extension tube, replacement only, each
K0047 Elevating legrest, upper hanger bracket, replacement only, each
K0050 Ratchet assembly, replacement only
K0051 Cam release assembly, footrest or legrest, replacement only, each
K0052 Swingaway, detachable footrests, replacement only, each
K0069 Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each
K0070 Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each
K0071 Front caster assembly, complete, with pneumatic tire, replacement only, each
K0072 Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
K0077 Front caster assembly, complete, with solid tire, replacement only, each
K0098 Drive belt for power wheelchair, replacement only
K0552 Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
L1906 Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf

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The last listing contains discontinued HCPCS Codes along with the cross-walked HCPCS Code (if applicable). However, not all discontinued HCPCS Codes will have a cross-walked HCPCS Code. The list is as follows:

HCPCS DISCONTINUE DATE CROSSWALK HCPCS CODE
A4466 12/31/2016 A4467
B9000 12/31/2016 B9002
E0628 12/31/2016 E0627
J0760 12/31/2016  
J1590 12/31/2016  
K0901 12/31/2016 L1851
K0902 12/31/2016 L1852
Q9981 12/31/2016 J8670

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