The following list identifies changes to level II Healthcare Common Procedure Coding System (HCPCS) codes for 2013.
Added Codes/Added Modifiers: New codes and modifiers are effective for dates of service on or after January 1, 2013.
Discontinued Codes/Deleted Modifiers: Codes or modifiers that are discontinued/deleted will continue to be valid for claims with dates of service on or before December 31, 2012, regardless of the date of claim submission. If there is a direct crosswalk for a discontinued/deleted code or modifier, it is listed in the table. The crosswalked codes are also “added” codes effective for dates of service on or after January 1, 2013.
There is no grace period that would allow submission of the discontinued code for dates of service in 2013.
Narrative Changes/Revised Modifiers: A description change for an existing code or modifier is effective for dates of service on or after January 1, 2013.
The appearance of a code in this list does not necessarily indicate coverage.
External Breast Prostheses
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| L8000 |
BREAST PROSTHESIS, MASTECTOMY BRA |
BREAST PROSTHESIS, MASTECTOMY BRA, WITHOUT INTEGRATED BREAST PROSTHESIS FORM, ANY SIZE, ANY TYPE |
| L8001 |
BREAST PROSTHESIS, MASTECTOMY BRA, WITH INTEGRATED BREAST PROSTHESIS FORM, UNILATERAL |
BREAST PROSTHESIS, MASTECTOMY BRA, WITH INTEGRATED BREAST PROSTHESIS FORM, UNILATERAL, ANY SIZE, ANY TYPE |
| L8002 |
BREAST PROSTHESIS, MASTECTOMY BRA, WITH INTEGRATED BREAST PROSTHESIS FORM, BILATERAL |
BREAST PROSTHESIS, MASTECTOMY BRA, WITH INTEGRATED BREAST PROSTHESIS FORM, BILATERAL, ANY SIZE, ANY TYPE |
Hospital Beds and Accessories
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| E0300 |
PEDIATRIC CRIB, HOSPITAL GRADE, FULLY ENCLOSED |
PEDIATRIC CRIB, HOSPITAL GRADE, FULLY ENCLOSED, WITH OR WITHOUT TOP ENCLOSURE |
Immunosuppressive Drugs
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| J8561 |
EVEROLIMUS, ORAL, 0.25 MG |
J7527 |
Added Code
| Code |
Narrative |
| J7527 |
EVEROLIMUS, ORAL, 0. 25 MG |
Impotence Aid
Added Code
| Code |
Narrative |
| L7902 |
TENSION RING, FOR VACUUM ERECTION DEVICE, ANY TYPE, REPLACEMENT ONLY, EACH |
Intravenous Immune Globulin
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| J1561 |
INJECTION, IMMUNE GLOBULIN, (GAMUNEX/GAMUNEX- C/GAMMAKED), NON-LYOPHILIZED LIQUID), 500 MG |
INJECTION, IMMUNE GLOBULIN, (GAMUNEX- C/GAMMAKED), NON-LYOPHILIZED (E. G. LIQUID), 500 MG |
| J1569 |
INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), INTRAVENOUS, NON-LYOPHILIZED, (E.G. LIQUID), 500 MG |
INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E. G. LIQUID), 500 MG |
Lower Limb Prostheses
Added Code
| Code |
Narrative |
| L5859 |
ADDITION TO LOWER EXTREMITY PROSTHESIS, ENDOSKELETAL KNEE-SHIN SYSTEM, POWERED AND PROGRAMMABLE FLEXION/EXTENSION ASSIST CONTROL, INCLUDES ANY TYPE MOTOR(S) |
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| L5972 |
ALL LOWER EXTREMITY PROSTHESES, FLEXIBLE KEEL FOOT (SAFE, STEN, BOCK DYNAMIC
OR EQUAL) |
ALL LOWER EXTREMITY PROSTHESES, FOOT, FLEXIBLE KEEL |
Ostomy Supplies
Added Code
| Code |
Narrative |
| A4435 |
OSTOMY POUCH, DRAINABLE, HIGH OUTPUT, WITH EXTENDED WEAR BARRIER (ONE-PIECE SYSTEM), WITH OR WITHOUT FILTER, EACH |
Oxygen and Oxygen Equipment
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| K0741 |
PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL, INCLUDES PORTABLE CONTAINER, REGULATOR, FLOWMETER, HUMIDIFIER, CANNULA OR MASK, AND TUBING, FOR CLUSTER HEADACHES |
NONE |
| K0742 |
PORTABLE OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT, FOR CLUSTER HEADACHES, FOR INITIAL MONTHS SUPPLY OR TO REPLACE USED CONTENTS |
NONE |
Pneumatic Compression Devices
Added Code
| Code |
Narrative |
| E0670 |
SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, INTEGRATED, 2 FULL LEGS AND TRUNK |
Surgical Dressings
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| A6021 |
COLLAGEN DRESSING, STERILE, PAD SIZE 16 SQ. IN. OR LESS, EACH |
COLLAGEN DRESSING, STERILE, SIZE 16 SQ. IN. OR LESS, EACH |
| A6022 |
COLLAGEN DRESSING, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH |
COLLAGEN DRESSING, STERILE, SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN. , EACH |
| A6023 |
COLLAGEN DRESSING, STERILE, PAD SIZE MORE THAN 48 SQ. IN., EACH |
COLLAGEN DRESSING, STERILE, SIZE MORE THAN 48 SQ. IN. , EACH |
Wheelchair Options/Accessories
Added Code
| Code |
Narrative |
| E2378 |
POWER WHEELCHAIR COMPONENT, ACTUATOR, REPLACEMENT ONLY |
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| E1020 |
RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR |
RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR, ANY TYPE |
| E2368 |
POWER WHEELCHAIR COMPONENT, MOTOR, REPLACEMENT ONLY |
POWER WHEELCHAIR COMPONENT, DRIVE WHEEL MOTOR, REPLACEMENT ONLY |
| E2369 |
POWER WHEELCHAIR COMPONENT, GEAR BOX, REPLACEMENT ONLY |
POWER WHEELCHAIR COMPONENT, DRIVE WHEEL GEAR BOX, REPLACEMENT ONLY |
| E2370 |
POWER WHEELCHAIR COMPONENT, MOTOR AND GEAR BOX COMBINATION, REPLACEMENT ONLY |
POWER WHEELCHAIR COMPONENT, INTEGRATED DRIVE WHEEL MOTOR AND GEAR BOX COMBINATION, REPLACEMENT ONLY |
Revision History
| Date |
Update |
| 12/17/2012 |
Published on PDAC website |