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March 27, 2025

2025 HCPCS Code Update – April Edition – Correct Coding

Joint DME MAC and PDAC Publication

The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2025. The tables contain only HCPCS codes applicable to items within Medicare DME MAC jurisdiction. There may be other 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 April 1, 2025.

Code Change Categories

  • Added Codes/Modifiers: Identifies newly created codes and modifiers. 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.
  • Discontinued Codes/Deleted Modifiers: Identifies codes and modifiers discontinued or deleted in the new cycle. These codes and modifiers continue to be valid for Medicare claims with dates of service either on or before March 31, 2025. There is no grace period for submission of a discontinued code/modifier for claims with dates of service after its effective end date. If there is a direct crosswalk for a discontinued/deleted code or modifier, the crosswalk code will be displayed in a table.
  • Narrative Changes: Identifies changes in the narrative descriptor for an existing code or modifier.

Added Codes

Ankle-Foot/Knee-Ankle-Foot Orthoses

Code Narrative
L1933 ANKLE FOOT ORTHOSIS, RIGID ANTERIOR TIBIAL SECTION, TOTAL CARBON FIBER OR EQUAL MATERIAL, PREFABRICATED, OFF-THE-SHELF
L1952 ANKLE FOOT ORTHOSIS, SPIRAL, (INSTITUTE OF REHABILITATIVE MEDICINE TYPE), PLASTIC OR OTHER MATERIAL, PREFABRICATED, OFF-THE-SHELF

Immunosuppressive Drugs

Code Narrative
J7521 TACROLIMUS, GRANULES, ORAL SUSPENSION, 0.1 MG

Lower Limb Prostheses

Code Narrative
L5827 ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, ELECTROMECHANICAL SWING AND STANCE PHASE CONTROL, WITH OR WITHOUT SHOCK ABSORPTION AND STANCE EXTENSION DAMPING

Wheelchair Options/Accessories

Code Narrative
E1032 WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE USED WITH JOYSTICK OR OTHER DRIVE CONTROL INTERFACE

Wheelchair Seating

Code Narrative
E1022 WHEELCHAIR TRANSPORTATION SECUREMENT SYSTEM, ANY TYPE INCLUDES ALL COMPONENTS AND ACCESSORIES
E1023 WHEELCHAIR TRANSIT SECUREMENT SYSTEM, INCLUDES ALL COMPONENTS AND ACCESSORIES
E1033 WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE FOR HEADREST, CUSHIONED, ANY TYPE
E1034 WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE FOR LATERAL TRUNK OR HIP SUPPORT, ANY TYPE

Miscellaneous

Code Narrative
A6515 GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, FULL LEG, EACH, CUSTOM
A6516 GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, FOOT, EACH, CUSTOM
A6517 GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, BELOW KNEE, EACH, CUSTOM
A6518 GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ARM, EACH, CUSTOM
A6519 GRADIENT COMPRESSION GARMENT, NOT OTHERWISE SPECIFIED, FOR NIGHTTIME USE, EACH
A6611 GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ABOVE KNEE, EACH, CUSTOM
E0201 PENILE CONTRACTURE DEVICE, MANUAL, GREATER THAN 3 LBS TRACTION FORCE
E1832 STATIC PROGRESSIVE STRETCH FINGER DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES
J0281 INJECTION, AMINOCAPROIC ACID, 1 GRAM
J1072 INJECTION, TESTOSTERONE CYPIONATE (AZMIRO), 1 MG
J1271 INJECTION, DOXYCYCLINE HYCLATE, 1 MG
J1299 INJECTION, ECULIZUMAB, 2 MG
J1308 INJECTION, FAMOTIDINE, 0.25 MG
J1808 INJECTION, FOLIC ACID, 0.1 MG
J1938 INJECTION, FUROSEMIDE, 1 MG
J2351 INJECTION, OCRELIZUMAB, 1 MG AND HYALURONIDASE-OCSQ
J2428 INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
J2804 INJECTION, RIFAMPIN, 1 MG
J2865 INJECTION, SULFAMETHOXAZOLE 5 MG AND TRIMETHOPRIM 1 MG
J9024 INJECTION, ATEZOLIZUMAB, 5 MG AND HYALURONIDASE-TQJS
J9038 INJECTION, AXATILIMAB-CSFR, 0.1 MG
J9054 INJECTION, BORTEZOMIB (BORUZU), 0.1 MG
J9161 INJECTION, DENILEUKIN DIFTITOX-CXDL, 1 MCG
L0720 CERVICAL-THORACIC-LUMBAR-SACRAL-ORTHOSES (CTLSO), ANTERIOR-POSTERIOR-LATERAL CONTROL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE
L6028 PARTIAL HAND INCLUDING FINGERS, FLEXIBLE OR NON-FLEXIBLE INTERFACE, ENDOSKELETAL SYSTEM, MOLDED TO PATIENT MODEL, FOR USE WITHOUT EXTERNAL POWER, NOT INCLUDING INSERTS DESCRIBED BY L6692
L6029 UPPER EXTREMITY ADDITION, TEST SOCKET/INTERFACE, PARTIAL HAND INCLUDING FINGERS
L6030 UPPER EXTREMITY ADDITION, EXTERNAL FRAME, PARTIAL HAND INCLUDING FINGERS
L6031 REPLACEMENT SOCKET/INTERFACE, PARTIAL HAND INCLUDING FINGERS, MOLDED TO PATIENT MODEL, FOR USE WITH OR WITHOUT EXTERNAL POWER
L6032 ADDITION TO UPPER EXTREMITY PROSTHESIS, PARTIAL HAND INCLUDING FINGERS, ULTRALIGHT MATERIAL (TITANIUM, CARBON FIBER OR EQUAL)
L6033 ADDITION TO UPPER EXTREMITY PROSTHESIS, PARTIAL HAND INCLUDING FINGERS, ACRYLIC MATERIAL
L6037 IMMEDIATE POST-SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING, INCLUDING FITTING ALIGNMENT AND SUSPENSION OF COMPONENTS, AND ONE CAST CHANGE, PARTIAL HAND INCLUDING FINGERS
L6700 UPPER EXTREMITY ADDITION, EXTERNAL POWERED FEATURE, MYOELECTRONIC CONTROL MODULE, ADDITIONAL EMG INPUTS, PATTERN-RECOGNITION DECODING INTENT MOVEMENT
L7406 ADDITION TO UPPER EXTREMITY, USER ADJUSTABLE, MECHANICAL, RESIDUAL LIMB VOLUME MANAGEMENT SYSTEM
Q5147 INJECTION, AFLIBERCEPT-AYYH (PAVBLU), BIOSIMILAR, 1 MG
Q5148 INJECTION, FILGRASTIM-TXID (NYPOZI), BIOSIMILAR, 1 MICROGRAM
Q5149 INJECTION, AFLIBERCEPT-ABZV (ENZEEVU), BIOSIMILAR, 1 MG
Q5150 INJECTION, AFLIBERCEPT-MRBB (AHZANTIVE), BIOSIMILAR, 1 MG
Q5151 INJECTION, ECULIZUMAB-AAGH (EPYSQLI), BIOSIMILAR, 2 MG
Q5152 INJECTION, ECULIZUMAB-AEEB (BKEMV), BIOSIMILAR, 2 MG

Discontinued Codes

External Breast Prostheses

Code Narrative
L8010 BREAST PROSTHESIS, MASTECTOMY SLEEVE

Miscellaneous

Code Narrative
J1094 INJECTION, DEXAMETHASONE ACETATE, 1 MG
J1300 INJECTION, ECULIZUMAB, 10 MG
J1810 INJECTION, DROPERIDOL AND FENTANYL CITRATE, UP TO 2 ML AMPULE
J1890 INJECTION, CEPHALOTHIN SODIUM, UP TO 1 GRAM
J1940 INJECTION, FUROSEMIDE, UP TO 20 MG
J9037 INJECTION, BELANTAMAB MAFODOTIN-BLMF, 0.5 MG
J9247 INJECTION, MELPHALAN FLUFENAMIDE, 1MG
Q5139 INJECTION, ECULIZUMAB-AEEB (BKEMV), BIOSIMILAR, 10 MG

Narrative Changes

Bowel Management Devices

Code Old Narrative New Narrative
A4453 RECTAL CATHETER FOR USE WITH THE MANUAL PUMP-OPERATED ENEMA SYSTEM, REPLACEMENT ONLY RECTAL CATHETER WITH OR WITHOUT BALLOON, FOR USE WITH ANY TYPE TRANSANAL IRRIGATION SYSTEM, EACH
A4459 MANUAL PUMP-OPERATED ENEMA SYSTEM, INCLUDES BALLOON, CATHETER AND ALL ACCESSORIES, REUSABLE, ANY TYPE MANUAL TRANSANAL IRRIGATION SYSTEM, INCLUDES WATER RESERVOIR, PUMP, TUBING, AND ACCESSORIES, WITHOUT CATHETER, ANY TYPE

Ankle-Foot/Knee-Ankle-Foot Orthoses

Code Old Narrative New Narrative
L1932 AFO, RIGID ANTERIOR TIBIAL SECTION, TOTAL CARBON FIBER OR EQUAL MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT ANKLE FOOT ORTHOSIS, RIGID ANTERIOR TIBIAL SECTION, TOTAL CARBON FIBER OR EQUAL MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE
L1951 ANKLE FOOT ORTHOSIS, SPIRAL, (INSTITUTE OF REHABILITATIVE MEDICINE TYPE), PLASTIC OR OTHER MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT ANKLE FOOT ORTHOSIS, SPIRAL, (INSTITUTE OF REHABILITATIVE MEDICINE TYPE), PLASTIC OR OTHER MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE
L1971 ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL WITH ANKLE JOINT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL WITH ANKLE JOINT, WITH OR WITHOUT DORSIFLEXION ASSIST, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT

Wheelchair Options/Accessories and Wheelchair Seating

Code Old Narrative New Narrative
E1028 WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE FOR JOYSTICK, OTHER CONTROL INTERFACE OR POSITIONING ACCESSORY WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE, OTHER

Miscellaneous

Code Old Narrative New Narrative
A6549 GRADIENT COMPRESSION GARMENT, NOT OTHERWISE SPECIFIED GRADIENT COMPRESSION GARMENT, NOT OTHERWISE SPECIFIED, FOR DAYTIME USE, EACH
A6583 GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, BELOW KNEE, 30-50 MMHG, EACH GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, BELOW KNEE, EACH
A6585 GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, ABOVE KNEE, EACH GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ABOVE KNEE, EACH
A6586 GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, FULL LEG, EACH GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ABOVE KNEE, EACH
A6587 GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, FOOT, EACH GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, FOOT, EACH
A6588 GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, ARM, EACH GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ARM, EACH
E1801 STATIC PROGRESSIVE STRETCH ELBOW DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES STATIC PROGRESSIVE STRETCH/PATIENT ACTUALIZED SERIAL STRETCH ELBOW DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES
E1811 STATIC PROGRESSIVE STRETCH KNEE DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES STATIC PROGRESSIVE STRETCH/PATIENT ACTUALIZED SERIAL STRETCH KNEE DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES
E1816 STATIC PROGRESSIVE STRETCH ANKLE DEVICE, FLEXION AND/OR EXTENSION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES STATIC PROGRESSIVE STRETCH/PATIENT ACTUALIZED SERIAL STRETCH ANKLE DEVICE, FLEXION AND/OR EXTENSION, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES
E1818 STATIC PROGRESSIVE STRETCH FOREARM PRONATION / SUPINATION DEVICE, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES STATIC PROGRESSIVE STRETCH/PATIENT ACTUALIZED SERIAL STRETCH FOREARM PRONATION / SUPINATION DEVICE, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES
E1841 STATIC PROGRESSIVE STRETCH SHOULDER DEVICE, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES STATIC PROGRESSIVE STRETCH/PATIENT ACTUALIZED SERIAL STRETCH SHOULDER DEVICE, WITH OR WITHOUT RANGE OF MOTION ADJUSTMENT, INCLUDES ALL COMPONENTS AND ACCESSORIES
J9073 INJECTION, CYCLOPHOSPHAMIDE (INGENUS), 5 MG INJECTION, CYCLOPHOSPHAMIDE (DR. REDDY'S), 5 MG
L6692 UPPER EXTREMITY ADDITION, SILICONE GEL INSERT OR EQUAL, EACH UPPER EXTREMITY ADDITION, SILICONE GEL INSERT OR EQUAL, WITH OR WITHOUT LOCKING MECHANISM, EACH
L6698 ADDITION TO UPPER EXTREMITY PROSTHESIS, BELOW ELBOW/ABOVE ELBOW, LOCK MECHANISM, EXCLUDES SOCKET INSERT ADDITION TO UPPER EXTREMITY PROSTHESIS, LOCK MECHANISM, EXCLUDES SOCKET INSERT

For questions about correct coding or products not listed on the DMECS Product Classification List (PCL), contact the Pricing, Data Analysis and Coding (PDAC) HCPCS Helpline at (877) 735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday. You may also visit the PDAC websiteExternal Website to chat with a representative or select the Contact UsExternal Website button at the top of the PDAC website for email, FAX, or postal mail information.

Publication History

March 27, 2025 Originally Published

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