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December 19, 2019

Retired: 2020 HCPCS Code Annual Update – Correct Coding

DME MAC Joint Publication

HCPCS Code Update - 2020

The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for 2020. The tables contain only the 2020 HCPCS codes applicable to items within Medicare DME MAC jurisdiction. There may be HCPCS code changes for items under the jurisdiction of other Medicare contractors. Consult those contractors for information regarding HCPCS codes within their areas of responsibility.

All HCPCS code changes are effective for claims with dates of service on or after January 1, 2020.

Code Change Categories

If there is a direct crosswalk for a discontinued/deleted code or modifier, the crosswalk code will be listed in the table. Crosswalked codes are effective for claims with dates of service on or after January 1, 2020.

There is no grace period for submission of a discontinued code/modifier for claims with dates of service in 2020.

For questions about correct doing, contact the PDAC Contact Center at 877-735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday, or email the PDAC by completing the DME PDAC Contact FormExternal Website located on the PDAC WebsiteExternal Website.

Code Change Tables

Listing of a code in the tables does not necessarily indicate coverage. Refer to the applicable Local Coverage Determination for information regarding Medicare reimbursement requirements.

Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686)

Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686)External Website

Added Code:

L2006: KNEE ANKLE FOOT DEVICE, ANY MATERIAL, SINGLE OR DOUBLE UPRIGHT, SWING AND/OR STANCE PHASE MICROPROCESSOR CONTROL WITH ADJUSTABILTY, INCLUDES ALL COMPONENTS (E.G., SENSORS, BATTERIES CHARGER) ANY TYPE ACTIVATION, WITH OR WITHOUT ANKLE JOINT(S), CUSTOM FABRICATED

External Breast Prosthesis (L33317)

External Breast Prosthesis (L33317)External Website

Added Code:

L8033: NIPPLE PROSTHESIS, CUSTOM FABRICATED, REUSABLE, ANY MATERIAL, ANY TYPE, EACH

Revised Long Code Narrative:

Code Old Narrative New Narrative
L8032 NIPPLE PROSTHESIS, REUSABLE, ANY TYPE, EACH NIPPLE PROSTHESIS, PREFABRICATED, REUSABLE, ANY TYPE, EACH

External Infusion Pumps (L33794)

External Infusion Pumps (L33794)External Website

Added Codes:

A4226: SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION PUMP WITH DOSAGE RATE ADJUSTMENT USING THERAPEUTIC CONTINUOUS GLUCOSE SENSING, PER WEEK
E0787: EXTERNAL AMBULATORY INFUSION PUMP, INSULIN, DOSAGE RATE ADJUSTMENT USING THERAPEUTIC CONTINUOUS GLUCOSE SENSING

Parenteral Nutrition (L33798)

Parenteral Nutrition (L33798)External Website

Added Code:

B4187: OMEGAVEN, 10 GRAMS LIPIDS

Revised Long Code Narrative:

Code Old Narrative New Narrative
B4185 PARENTAL NUTRITION SOLUTION, PER 10 GRAMS LIPIDS PARENTERAL NUTRITION SOLUTION, NOT OTHERWISE SPECIFIED, 10 GRAMS LIPIDS

Wheelchair Options/Accessories (L33792)

Wheelchair Options/Accessories (L33792)External Website

Added Code:

E2398: WHEELCHAIR ACCESSORY, DYNAMIC POSITIONING HARDWARE FOR BACK

Miscellaneous Codes

Added Codes:

K1001: ELECTRONIC POSITIONAL OBSTRUCTIVE SLEEP APNEA TREATMENT, WITH SENSOR, INCLUDES ALL COMPONENTS AND ACCESSORIES, ANY TYPE
K1002: CRANIAL ELECTROTHERAPY STIMULATION (CES) SYSTEM, INCLUDES ALL SUPPLIES AND ACCESSORIES, ANY TYPE
K1003: WHIRLPOOL TUB, WALK-IN, PORTABLE
K1004: LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE FOR HOME USE, INCLUDES ALL COMPONENTS AND ACCESSORIES
K1005: DISPOSABLE COLLECTION AND STORAGE BAG FOR BREAST MILK, ANY SIZE, ANY TYPE, EACH

Publication History

Date of Change: Description
December 19, 2019: Original Publication
February 20, 2020: Article Retired: Revised version posted
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