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November 28, 2022

January 2023 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes

The following information is based on the January 2023 Healthcare Common Procedure Coding System (HCPCS) file. There are several updates that will be effective January 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 January 1, 2023.

HCPCS DESCRIPTION
A4239 Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
E2103 Non-adjunctive, non-implanted continuous glucose monitor or receiver
J0134 Injection, acetaminophen (fresenius kabi) not therapeutically equivalent to j0131, 10 mg
J0136 Injection, acetaminophen (b braun) not therapeutically equivalent to j0131, 10 mg
J0173 Injection, epinephrine (belcher) not therapeutically equivalent to j0171, 0.1 mg
J0225 Injection, vutrisiran, 1 mg
J0283 Injection, amiodarone hydrochloride (nexterone), 30 mg
J0611 Injection, calcium gluconate (wg critical care), per 10 ml
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg
J0701 Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg
J0703 Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg
J0877 Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg
J0891 Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)
J0892 Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)
J0893 Injection, decitabine (sun pharma) not therapeutically equivalent to j0894, 1 mg
J0898 Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)
J0899 Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)
J1456 Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg
J1574 Injection, ganciclovir sodium (exela) not therapeutically equivalent to j1570, 500 mg
J1611 Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg
J1643 Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units
J2021 Injection, linezolid (hospira) not therapeutically equivalent to j2020, 200 mg
J2184 Injection, meropenem (b. braun) not therapeutically equivalent to j2185, 100 mg
J2247 Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
J2251 Injection, midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250, per 1 mg
J2272 Injection, morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270, up to 10 mg
J2281 Injection, moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280, 100 mg
J2311 Injection, naloxone hydrochloride (zimhi), 1 mg
J2327 Injection, risankizumab-rzaa, intravenous, 1 mg
J2401 Injection, chloroprocaine hydrochloride, per 1 mg
J2402 Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg
J3244 Injection, tigecycline (accord) not therapeutically equivalent to j3243, 1 mg
J3371 Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
J3372 Injection, vancomycin hcl (xellia) not therapeutically equivalent to j3370, 500 mg
J9046 Injection, bortezomib, (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg
J9048 Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg
J9049 Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg
J9393 Injection, fulvestrant (teva) not therapeutically equivalent to j9395, 25 mg
J9394 Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg
Q5126 Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg

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

HCPCS DESCRIPTION
A4238 Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
E2102 Adjunctive, non-implanted continuous glucose monitor or receiver
J0131 Injection, acetaminophen, not otherwise specified,10 mg
J0610 Injection, calcium gluconate (fresenius kabi), per 10 ml
J9041 Injection, bortezomib, 0.1 mg

The following HCPCS codes have coverage and description/verbiage changes that will be effective January 1, 2023. Coverage changed from invalid for Medicare to non-covered by Medicare Statute.

HCPCS DESCRIPTION
A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply
A9277 Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
A9278 Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system

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

HCPCS DISCONTINUE DATE CROSSWALK HCPCS CODE
J2400 12/31/2022 None
J9044 12/31/2022 None
K0553 12/31/2022 A4239
K0554 12/31/2022 E2103

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