April 3, 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 |
K1035 | Molecular diagnostic test reader, nonprescription self-administered and self-collected use, fda approved, authorized or cleared |
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 |