Joint DME MAC and PDAC Publication
The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2024. 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, 2024.
Code Change Categories
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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.
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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, 2024. 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.
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Narrative Changes: Identifies changes in the narrative descriptor for an existing code or modifier.
Added Codes
Glucose Monitors
| Code |
Narrative |
| A4271 |
INTEGRATED LANCING AND BLOOD SAMPLE TESTING CARTRIDGES FOR HOME BLOOD GLUCOSE MONITOR, PER MONTH |
| E2104 |
HOME BLOOD GLUCOSE MONITOR FOR USE WITH INTEGRATED LANCING/BLOOD SAMPLE TESTING CARTRIDGE |
Immunosuppressive Drugs
| Code |
Narrative |
| J2919 |
INJECTION METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG |
Lower Limb Prostheses
| Code |
Narrative |
| L5783 |
ADDITION TO LOWER EXTREMITY, USER ADJUSTABLE, MECHANICAL, RESIDUAL LIMB VOLUME MANAGEMENT SYSTEM |
| L5841 |
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, PNEUMATIC SWING, AND STANCE PHASE CONTROL |
Walkers
| Code |
Narrative |
| E0152 |
WALKER, BATTERY POWERED, WHEELED, FOLDING, ADJUSTABLE OR FIXED HEIGHT |
Wheelchair Options/Accessories
| Code |
Narrative |
| E2298 |
COMPLEX REHABILITATIVE POWER WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM, ANY TYPE |
Miscellaneous
| Code |
Narrative |
| A4593 |
NEUROMODULATION STIMULATOR SYSTEM, ADJUNCT TO REHABILITATION THERAPY REGIME, CONTROLLER |
| A4594 |
NEUROMODULATION STIMULATOR SYSTEM, ADJUNCT TO REHABILITATION THERAPY REGIME, MOUTHPIECE EACH |
| E0468 |
HOME VENTILATOR, DUAL-FUNCTION RESPIRATORY DEVICE, ALSO PERFORMS ADDITIONAL FUNCTION OF COUGH STIMULATION, INCLUDES ALL ACCESSORIES, COMPONENTS AND SUPPLIES FOR ALL FUNCTIONS |
| E0736 |
TRANSCUTANEOUS TIBIAL NERVE STIMULATOR |
| E0738 |
UPPER EXTREMITY REHABILITATION SYSTEM PROVIDING ACTIVE ASSISTANCE TO FACILITATE MUSCLE RE-EDUCATION, INCLUDE MICROPROCESSOR, ALL COMPONENTS AND ACCESSORIES |
| E0739 |
REHAB SYSTEM WITH INTERACTIVE INTERFACE PROVIDING ACTIVE ASSISTANCE IN REHABILITATION THERAPY, INCLUDES ALL COMPONENTS AND ACCESSORIES, MOTORS, MICROPROCESSORS, SENSORS |
| K1037 |
DOCKING STATION FOR USE WITH ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY |
| L1320 |
THORACIC, PECTUS CARINATUM ORTHOSIS, STERNAL COMPRESSION, RIGID CIRCUMFERENTIAL FRAME WITH ANTERIOR AND POSTERIOR RIGID PADS, CUSTOM FABRICATED |
Discontinued Codes
Immunosuppressive Drugs
| Code |
Narrative |
| J2920 |
INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG |
| J2930 |
INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG |
Wheelchair Options/Accessories
| Code |
Narrative |
| E2300 |
WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM, ANY TYPE |
Narrative Changes
Immunosuppressive Drugs
| Code |
Old Narrative |
New Narrative |
| J7516 |
CYCLOSPORIN, PARENTERAL, 250 MG |
INJECTION, CYCLOSPORINE, 250 MG |
Miscellaneous
| Code |
Old Narrative |
New Narrative |
| E2001 |
SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC, ANY TYPE, FOR USE WITH EXTERNAL URINE MANAGEMENT SYSTEM |
SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC, ANY TYPE, FOR USE WITH EXTERNAL URINE AND/OR FECAL MANAGEMENT SYSTEM |
For questions about correct coding or products not listed on the DMECS Product Classification List (PCL), contact the 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 website to chat with a representative or select the Contact Us button at the top of the PDAC website for email, FAX or postal mail information.
Revision History
| Date |
Update |
| 04/16/2024 |
Published on PDAC website |