2024 HCPCS Code Update – October 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 October 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 October 1, 2024.
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 September 30, 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.
- Narrative Changes: Identifies changes in the narrative descriptor for an existing code or modifier.
Added Codes
External Infusion Pumps
| Code | Narrative |
|---|---|
| J1171 |
INJECTION, HYDROMORPHONE, 0.1 MG |
Knee Orthoses
| Code | Narrative |
|---|---|
| L1821 | KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, OFF THE SHELF |
Speech Generating Devices (SGD)
| Code | Narrative |
|---|---|
| E2513 | ACCESSORY FOR SPEECH GENERATING DEVICE, ELECTROMYOGRAPHIC SENSOR |
Miscellaneous
| Code | Narrative |
|---|---|
| A4543 | SUPPLIES FOR TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR, FOR NERVES IN THE AURICULAR REGION, PER MONTH |
| A4544 | ELECTRODE FOR EXTERNAL LOWER EXTREMITY NERVE STIMULATOR FOR RESTLESS LEGS SYNDROME |
| A4545 | SUPPLIES AND ACCESSORIES FOR EXTERNAL TIBIAL NERVE STIMULATOR (E.G., SOCKS, GEL PADS, ELECTRODES, ETC.), NEEDED FOR ONE MONTH |
| A7021 | SUPPLIES AND ACCESSORIES FOR LUNG EXPANSION AIRWAY CLEARANCE, CONTINUOUS HIGH FREQUENCY OSCILLATION, AND NEBULIZATION DEVICE (E.G., HANDSET, NEBULIZER KIT, BIOFILTER) |
| E0469 | LUNG EXPANSION AIRWAY CLEARANCE, CONTINUOUS HIGH FREQUENCY OSCILLATION, AND NEBULIZATION DEVICE |
| E0683 | NON-PNEUMATIC, NON-SEQUENTIAL, PERISTALTIC WAVE COMPRESSION PUMP |
| E0715 | INTRAVAGINAL DEVICE INTENDED TO STRENGTHEN PELVIC FLOOR MUSCLES DURING KEGEL EXERCISES |
| E0716 | SUPPLIES AND ACCESSORIES FOR INTRAVAGINAL DEVICE INTENDED TO STRENGTHEN PELVIC FLOOR MUSCLES DURING KEGEL EXERCISES |
| E0721 | TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR FOR NERVES IN THE AURICULAR REGION |
| E0737 | TRANSCUTANEOUS TIBIAL NERVE STIMULATOR, CONTROLLED BY PHONE APPLICATION |
| E0743 | EXTERNAL LOWER EXTREMITY NERVE STIMULATOR FOR RESTLESS LEGS SYNDROME, EACH |
| E0767 | INTRABUCCAL, SYSTEMIC DELIVERY OF AMPLITUDE-MODULATED, RADIOFREQUENCY ELECTROMAGNETIC FIELD DEVICE, FOR CANCER TREATMENT, INCLUDES ALL ACCESSORIES |
| E3200 | GAIT MODULATION SYSTEM, RHYTHMIC AUDITORY STIMULATION, INCLUDING RESTRICTED THERAPY SOFTWARE, ALL COMPONENTS AND ACCESSORIES, PRESCRIPTION ONLY |
| J0138 | INJECTION, ACETAMINOPHEN 10 MG AND IBUPROFEN 3 MG |
| J1749 | INJECTION, ILOPROST, 0.1 MCG |
| J2002 | INJECTION, LIDOCAINE HCL IN 5% DEXTROSE, 1 MG |
| J2003 | INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG |
| J2004 | INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG |
| J2252 | INJECTION, MIDAZOLAM IN 0.8% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG |
| J2253 | INJECTION, MIDAZOLAM (SEIZALAM), 1 MG |
| J2601 | INJECTION, VASOPRESSIN (BAXTER), 1 UNIT |
| J8522 | CAPECITABINE, ORAL, 50 MG |
| J8541 | DEXAMETHASONE (HEMADY), ORAL, 0.25 MG |
| J9329 | INJECTION, TISLELIZUMAB-JSGR, 1MG |
| L1006 | SCOLIOSIS ORTHOSIS, SAGITTAL-CORONAL CONTROL PROVIDED BY A RIGID LATERAL FRAME, EXTENDS FROM AXILLA TO TROCHANTER, INCLUDES ALL ACCESSORY PADS, STRAPS AND INTERFACE, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE |
| L1653 | HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRICATED, OFF THE SHELF |
| L8720 | EXTERNAL LOWER EXTREMITY SENSORY PROSTHESIS, CUTANEOUS STIMULATION OF MECHANORECEPTORS PROXIMAL TO THE ANKLE, PER LEG |
| L8721 | RECEPTOR SOLE FOR USE WITH L8720, REPLACEMENT, EACH |
| Q0519 | PHARMACY SUPPLYING FEE FOR HIV PRE-EXPOSURE PROPHYLAXIS FDA APPROVED PRESCRIPTION INJECTABLE DRUG, PER 30-DAYS |
| Q0520 | PHARMACY SUPPLYING FEE FOR HIV PRE-EXPOSURE PROPHYLAXIS FDA APPROVED PRESCRIPTION INJECTABLE DRUG, PER 60-DAYS |
| Q5135 | INJECTION, TOCILIZUMAB-AAZG (TYENNE), BIOSIMILAR, 1 MG |
| Q5136 | INJECTION, DENOSUMAB-BBDZ (JUBBONTI/WYOST), BIOSIMILAR, 1 MG |
Discontinued Codes
External Infusion Pumps
| Code | Narrative |
|---|---|
| J1170 | INJECTION, HYDROMORPHONE, UP TO 4 MG |
Miscellaneous
| Code | Narrative |
|---|---|
| J2001 | INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG |
| J8520 | CAPECITABINE, ORAL, 150 MG |
| J8521 | CAPECITABINE, ORAL, 500 MG |
| J9258 | INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES (TEVA), NOT THERAPEUTICALLY EQUIVALENT TO J9264, 1 MG |
Narrative Changes
Glucose Monitors
| Code | Old Narrative | New Narrative |
|---|---|---|
| A4271 | INTEGRATED LANCING AND BLOOD SAMPLE TESTING CARTRIDGES FOR HOME BLOOD GLUCOSE MONITOR, PER MONTH | INTEGRATED LANCING AND BLOOD SAMPLE TESTING CARTRIDGES FOR HOME BLOOD GLUCOSE MONITOR, PER 50 TESTS |
Knee Orthoses
| Code | Old Narrative | New Narrative |
|---|---|---|
| L1820 | KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT | KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE |
Miscellaneous
| Code | Old Narrative | New Narrative |
|---|---|---|
| E0739 | REHAB SYSTEM WITH INTERACTIVE INTERFACE PROVIDING ACTIVE ASSISTANCE IN REHABILITATION THERAPY, INCLUDES ALL COMPONENTS AND ACCESSORIES, MOTORS, MICROPROCESSORS, SENSORS | REHABILITATION SYSTEM WITH INTERACTIVE INTERFACE PROVIDING ACTIVE ASSISTANCE IN REHABILITATION THERAPY, INCLUDES ALL COMPONENTS AND ACCESSORIES, MOTORS, MICROPROCESSORS, SENSORS |
| J2251 | INJECTION, MIDAZOLAM HYDROCHLORIDE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J2250, PER 1 MG | INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG |
| J9172 | INJECTION, DOCETAXEL (INGENUS), NOT THERAPEUTICALLY EQUIVALENT TO J9171, 1 MG | INJECTION, DOCETAXEL (DOCIVYX), 1 MG |
| L1652 | HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT, ANY TYPE | HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE |
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 |
|---|---|
| 09/30/2024 | Published on PDAC website |
Last Updated: 09/30/2024