Product Classification List (PCL) Updates and Crosswalks - Effective April 1, 2025
On February 28, 2025, the Centers for Medicare & Medicaid Services (CMS) published the HCPCS Quarterly Update for April 2025. Included within the update were newly created, revised and terminated HCPCS level II codes. Several of these updates affected previous CMS and PDAC coding decisions for products listed on the Durable Medical Equipment Coding System (DMECS) Product Classification List (PCL). Reference the 2025 HCPCS Code Update – April Edition – Correct Coding advisory article for a list of changes to Level II HCPCS codes within the DME MAC jurisdiction.
It is the responsibility of the PDAC to maintain the integrity of coding decisions listed on the PCL. As a result of these recent updates, and for the HCPCS codes listed in the table below, the PDAC identified over 1,400 coding decisions which required additional code verification review (CVR). Where possible, products were crosswalked to an appropriate HCPCS code(s) effective April 1, 2025. For products where the PDAC was unable to determine an appropriate HCPCS code, an end date was applied to the listing effective March 31, 2025.
| Code/Code Pairings | Narrative (as of 4/1/2025) | |||||
|---|---|---|---|---|---|---|
| A4453 | RECTAL CATHETER WITH OR WITHOUT BALLOON, FOR USE WITH ANY TYPE TRANSANAL IRRIGATION SYSTEM, EACH | |||||
| A4459 | MANUAL TRANSANAL IRRIGATION SYSTEM, INCLUDES WATER RESERVOIR, PUMP, TUBING, AND ACCESSORIES, WITHOUT CATHETER, ANY TYPE | |||||
| A6549 | GRADIENT COMPRESSION GARMENT, NOT OTHERWISE SPECIFIED, FOR DAYTIME USE, EACH | |||||
| A6583 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, BELOW KNEE, EACH | |||||
| A6585 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ABOVE KNEE, EACH | |||||
| A6586 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, FULL LEG, EACH | |||||
| A6587 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, FOOT, EACH | |||||
| A6588 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, ARM, EACH | |||||
| E1028 | WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE, OTHER | |||||
| L1932 | 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 ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE | |||||
| L1971+L22XX | ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL WITH ANKLE JOINT, WITH OR WITHOUT DORSIFLEXION ASSIST, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT + ANY CUSTOM FABRICATED LOWER EXTREMITY ORTHOSES ADDITION |
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| L1971+L22XX |
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| L5828+L5845+L5848* |
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| L8010 | BREAST PROSTHESIS, MASTECTOMY SLEEVE | |||||
| * For lower extremity prosthetics that do not include fluid features | ||||||
Manufacturers and distributors with products on the PCL associated with these HCPCS codes should review their listings to ensure they agree with the newly assigned HCPCS code(s).
A new CVR application must be submitted to PDAC for the following reasons:
| 1. | To request a new CVR letter for any crosswalked product |
| 2. | To request additional or different level II HCPCS codes for any crosswalked product |
| 3. | To request that an end dated product/code assignment be code verified by the PDAC and relisted on the PCL |
Information on how to submit a CVR application can be found on the PDAC website under Code Verification Request.
For questions about correct coding or products not listed on the DMECS Product Classification List,, 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 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.
| Date | Update |
|---|---|
| 4/4/2025 | Published on PDAC website |