November 27, 2023
January 2024 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes and Modifiers
The following information is based on the January 2024 Healthcare Common Procedure Coding System (HCPCS) file. There are several updates that will be effective in January 2024. 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 in January 2024.
HCPCS | DESCRIPTION | Effective Date |
---|---|---|
A4287 | Disposable collection and storage bag for breast milk, any size, any type, each | 01/01/2024 |
A4457 | Enema tube, with or without adapter, any type, replacement only, each | 01/01/2024 |
A4468 | Exsufflation belt, includes all supplies and accessories | 01/01/2024 |
A4540 | Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm | 01/01/2024 |
A4541 | Monthly supplies for use of device coded at e0733 | 01/01/2024 |
A4542 | Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist | 01/01/2024 |
A6520 | Gradient compression garment, glove, padded, for nighttime use, each | 01/01/2024 |
A6521 | Gradient compression garment, glove, padded, for nighttime use, custom, each | 01/01/2024 |
A6522 | Gradient compression garment, arm, padded, for nighttime use, each | 01/01/2024 |
A6523 | Gradient compression garment, arm, padded, for nighttime use, custom, each | 01/01/2024 |
A6524 | Gradient compression garment, lower leg and foot, padded, for nighttime use, each | 01/01/2024 |
A6525 | Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each | 01/01/2024 |
A6526 | Gradient compression garment, full leg and foot, padded, for nighttime use, each | 01/01/2024 |
A6527 | Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each | 01/01/2024 |
A6528 | Gradient compression garment, bra, for nighttime use, each | 01/01/2024 |
A6529 | Gradient compression garment, bra, for nighttime use, custom, each | 01/01/2024 |
A6552 | Gradient compression stocking, below knee, 30-40 mmhg, each | 01/01/2024 |
A6553 | Gradient compression stocking, below knee, 30-40 mmhg, custom, each | 01/01/2024 |
A6554 | Gradient compression stocking, below knee, 40 mmhg or greater, each | 01/01/2024 |
A6555 | Gradient compression stocking, below knee, 40 mmhg or greater, custom, each | 01/01/2024 |
A6556 | Gradient compression stocking, thigh length, 18-30 mmhg, custom, each | 01/01/2024 |
A6557 | Gradient compression stocking, thigh length, 30-40 mmhg, custom, each | 01/01/2024 |
A6558 | Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each | 01/01/2024 |
A6559 | Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each | 01/01/2024 |
A6560 | Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each | 01/01/2024 |
A6561 | Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each | 01/01/2024 |
A6562 | Gradient compression stocking, waist length, 18-30 mmhg, custom, each | 01/01/2024 |
A6563 | Gradient compression stocking, waist length, 30-40 mmhg, custom, each | 01/01/2024 |
A6564 | Gradient compression stocking, waist length, 40 mmhg or greater, custom, each | 01/01/2024 |
A6565 | Gradient compression gauntlet, custom, each | 01/01/2024 |
A6566 | Gradient compression garment, neck/head, each | 01/01/2024 |
A6567 | Gradient compression garment, neck/head, custom, each | 01/01/2024 |
A6568 | Gradient compression garment, torso and shoulder, each | 01/01/2024 |
A6569 | Gradient compression garment, torso/shoulder, custom, each | 01/01/2024 |
A6570 | Gradient compression garment, genital region, each | 01/01/2024 |
A6571 | Gradient compression garment, genital region, custom, each | 01/01/2024 |
A6572 | Gradient compression garment, toe caps, each | 01/01/2024 |
A6573 | Gradient compression garment, toe caps, custom, each | 01/01/2024 |
A6574 | Gradient compression arm sleeve and glove combination, custom, each | 01/01/2024 |
A6575 | Gradient compression arm sleeve and glove combination, each | 01/01/2024 |
A6576 | Gradient compression arm sleeve, custom, medium weight, each | 01/01/2024 |
A6577 | Gradient compression arm sleeve, custom, heavy weight, each | 01/01/2024 |
A6578 | Gradient compression arm sleeve, each | 01/01/2024 |
A6579 | Gradient compression glove, custom, medium weight, each | 01/01/2024 |
A6580 | Gradient compression glove, custom, heavy weight, each | 01/01/2024 |
A6581 | Gradient compression glove, each | 01/01/2024 |
A6582 | Gradient compression gauntlet, each | 01/01/2024 |
A6583 | Gradient compression wrap with adjustable straps, below knee, 30-50 mmhg, each | 01/01/2024 |
A6584 | Gradient compression wrap with adjustable straps, not otherwise specified | 01/01/2024 |
A6585 | Gradient pressure wrap with adjustable straps, above knee, each | 01/01/2024 |
A6586 | Gradient pressure wrap with adjustable straps, full leg, each | 01/01/2024 |
A6587 | Gradient pressure wrap with adjustable straps, foot, each | 01/01/2024 |
A6588 | Gradient pressure wrap with adjustable straps, arm, each | 01/01/2024 |
A6589 | Gradient pressure wrap with adjustable straps, bra, each | 01/01/2024 |
A6593 | Accessory for gradient compression garment or wrap with adjustable straps, non-otherwise specified | 01/01/2024 |
A6594 | Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each | 01/01/2024 |
A6595 | Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each | 01/01/2024 |
A6596 | Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each | 01/01/2024 |
A6597 | Gradient compression bandage roll, elastic long stretch, linear yard, any width, each | 01/01/2024 |
A6598 | Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each | 01/01/2024 |
A6599 | Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each | 01/01/2024 |
A6600 | Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each | 01/01/2024 |
A6601 | Gradient compression bandaging supply, high density foam pad, any size or shape, each | 01/01/2024 |
A6602 | Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each | 01/01/2024 |
A6603 | Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each | 01/01/2024 |
A6604 | Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each | 01/01/2024 |
A6605 | Gradient compression bandaging supply, padded foam, per linear yard, any width, each | 01/01/2024 |
A6606 | Gradient compression bandaging supply, padded textile, per linear yard, any width, each | 01/01/2024 |
A6607 | Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each | 01/01/2024 |
A6608 | Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each | 01/01/2024 |
A6609 | Gradient compression bandaging supply, not otherwise specified | 01/01/2024 |
A6610 | Gradient compression stocking, below knee, 18-30 mmhg, custom, each | 01/01/2024 |
A7023 | Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical | 01/01/2024 |
E0492 | Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application | 01/01/2024 |
E0493 | Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply | 01/01/2024 |
E0530 | Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type | 01/01/2024 |
E0678 | Non-pneumatic sequential compression garment, full leg | 01/01/2024 |
E0679 | Non-pneumatic sequential compression garment, half leg | 01/01/2024 |
E0680 | Non-pneumatic compression controller with sequential calibrated gradient pressure | 01/01/2024 |
E0681 | Non-pneumatic compression controller without calibrated gradient pressure | 01/01/2024 |
E0682 | Non-pneumatic sequential compression garment, full arm | 01/01/2024 |
E0732 | Cranial electrotherapy stimulation (ces) system, any type | 01/01/2024 |
E0733 | Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve | 01/01/2024 |
E0734 | External upper limb tremor stimulator of the peripheral nerves of the wrist | 01/01/2024 |
E0735 | Non-invasive vagus nerve stimulator | 01/01/2024 |
E1301 | Whirlpool tub, walk-in, portable | 01/01/2024 |
E2001 | Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system | 01/01/2024 |
E3000 | Speech volume modulation system, any type, including all components and accessories | 01/01/2024 |
J0184 | Injection, amisulpride, 1 mg | 01/01/2024 |
J0217 | Injection, velmanase alfa-tycv, 1 mg | 01/01/2024 |
J0391 | Injection, artesunate, 1 mg | 01/01/2024 |
J0402 | Injection, aripiprazole (abilify asimtufii), 1 mg | 01/01/2024 |
J0576 | Injection, buprenorphine extended-release (brixadi), 1 mg | 01/01/2024 |
J0688 | Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg | 01/01/2024 |
J0750 | Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) | 01/02/2024 |
J0751 | Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) | 01/02/2024 |
J0799 | Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified | 01/02/2024 |
J0873 | Injection, daptomycin (xellia) not therapeutically equivalent to j0878, 1 mg | 01/01/2024 |
J1105 | Dexmedetomidine, oral, 1 mcg | 01/01/2024 |
J1246 | Injection, dinutuximab, 0.1 mg | 01/01/2024 |
J1304 | Injection, tofersen, 1 mg | 01/01/2024 |
J1412 | Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes | 01/01/2024 |
J1413 | Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose | 01/01/2024 |
J1596 | Injection, glycopyrrolate, 0.1 mg | 01/01/2024 |
J1939 | Injection, bumetanide, 0.5 mg | 01/01/2024 |
J2404 | Injection, nicardipine, 0.1 mg | 01/01/2024 |
J2508 | Injection, pegunigalsidase alfa-iwxj, 1 mg | 01/01/2024 |
J2679 | Injection, fluphenazine hcl, 1.25 mg | 01/01/2024 |
J2799 | Injection, risperidone (uzedy), 1 mg | 01/01/2024 |
J3401 | Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml | 01/01/2024 |
J3425 | Injection, hydroxocobalamin, 10 mcg | 01/01/2024 |
J9052 | Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg | 01/01/2024 |
J9072 | Injection, cyclophosphamide, (dr. reddy's), 5 mg | 01/01/2024 |
J9172 | Injection, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg | 01/01/2024 |
J9255 | Injection, methotrexate (accord) not therapeutically equivalent to j9250 and j9260, 50 mg | 01/01/2024 |
J9258 | Injection, paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264, 1 mg | 01/01/2024 |
J9286 | Injection, glofitamab-gxbm, 2.5 mg | 01/01/2024 |
J9321 | Injection, epcoritamab-bysp, 0.16 mg | 01/01/2024 |
J9324 | Injection, pemetrexed (pemrydi rtu), 10 mg | 01/01/2024 |
J9333 | Injection, rozanolixizumab-noli, 1 mg | 01/01/2024 |
J9334 | Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc | 01/01/2024 |
L3161 | Foot, adductus positioning device, adjustable | 01/01/2024 |
L5615 | Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control | 01/01/2024 |
L5926 | Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type | 01/01/2024 |
Q0516 | Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 30-days | 01/02/2024 |
Q0517 | Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 60-days | 01/02/2024 |
Q0518 | Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 90-days | 01/02/2024 |
Q5132 | Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg | 01/01/2024 |
The following HCPCS codes have description/verbiage changes that will be effective in January 2024.
HCPCS | DESCRIPTION | Effective Date |
---|---|---|
A6531 | Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each | 01/01/2024 |
A6532 | Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each | 01/01/2024 |
A6535 | Gradient compression stocking, thigh length, 40 mmhg or greater, each | 01/01/2024 |
A6538 | Gradient compression stocking, full length/chap style, 40 mmhg or greater, each | 01/01/2024 |
A6541 | Gradient compression stocking, waist length, 40 mmhg or greater, each | 01/01/2024 |
A6545 | Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each | 01/01/2024 |
A6549 | Gradient compression garment, not otherwise specified | 01/01/2024 |
J0739 | Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) | 01/02/2024 |
Q2052 | Services, supplies and accessories used in the home for the administration of intravenous immune globulin (ivig) | 01/01/2024 |
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 |
---|---|---|
J9160 | 12/31/2023 | |
K1001 | 12/31/2023 | E0530 |
K1002 | 12/31/2023 | E0732 |
K1003 | 12/31/2023 | E1301 |
K1005 | 12/31/2023 | A4287 |
K1006 | 12/31/2023 | E2001 |
K1009 | 12/31/2023 | E3000 |
K1013 | 12/31/2023 | A4457 |
K1014 | 12/31/2023 | L5615 |
K1015 | 12/31/2023 | L3161 |
K1016 | 12/31/2023 | E0733 |
K1017 | 12/31/2023 | A4541 |
K1018 | 12/31/2023 | E0734 |
K1019 | 12/31/2023 | A4542 |
K1020 | 12/31/2023 | E0735 |
K1021 | 12/31/2023 | A4468 |
K1022 | 12/31/2023 | L5926 |
K1023 | 12/31/2023 | A4540 |
K1024 | 12/31/2023 | E0680 |
K1025 | 12/31/2023 | E0682 |
K1026 | 12/31/2023 | A7023 |
K1028 | 12/31/2023 | E0492 |
K1029 | 12/31/2023 | E0493 |
K1031 | 12/31/2023 | E0681 |
K1032 | 12/31/2023 | E0678 |
K1033 | 12/31/2023 | E0679 |
The following listing contains HCPCS codes with changes to the CMS Pricing Categories effective in January 2024.
HCPCS | New Pricing Category | Effective Date |
---|---|---|
A6530 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6533 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6534 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6535 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6536 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6537 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6538 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6539 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6540 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6541 | Lymphedema Compression Treatment Items | 01/01/2024 |
A6549 | Lymphedema Compression Treatment Items | 01/01/2024 |
K1007 | Orthotics, prosthetics, prosthetic devices & vision services | 01/01/2024 |
L8701 | Orthotics, prosthetics, prosthetic devices & vision services | 01/01/2024 |
L8702 | Orthotics, prosthetics, prosthetic devices & vision services | 01/01/2024 |