Joint DME MAC and PDAC Publication
The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for October 2023. 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, 2023.
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, 2023. 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. There were no narrative changes in this cycle.
Added Codes
Enteral Nutrition
| Code |
Narrative |
| B4148 |
ENTERAL FEEDING SUPPLY KIT; ELASTOMERIC CONTROL FED, PER DAY, INCLUDES BUT NOT LIMITED TO FEEDING/FLUSHING SYRINGE, ADMINISTRATION SET TUBING, DRESSINGS, TAPE |
Neuromuscular Electrical Stimulation (NMES)
| Code |
Narrative |
| E0490 |
POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY HARDWARE REMOTE
|
| E0491 |
ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, USED IN CONJUNCTION WITH THE POWER SOURCE AND CONTROL ELECTRONICS UNIT, CONTROLLED BY HARDWARE REMOTE, 90-DAY SUPPLY |
Lower Limb Orthotic
| Code |
Narrative |
| L1681 |
HIP ORTHOSIS, BILATERAL HIP JOINTS AND THIGH CUFFS, ADJUSTABLE FLEXION, EXTENSION, ABDUCTION CONTROL OF HIP JOINT, POSTOPERATIVE HIP ABDUCTION TYPE, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE |
Lower Limb Prosthetic
| Code |
Narrative |
| L5991 |
ADDITION TO LOWER EXTREMITY PROSTHESES, OSSEOINTEGRATED EXTERNAL PROSTHETIC CONNECTOR |
Miscellaneous
| Code |
Narrative |
| A9156 |
ORAL MUCOADHESIVE, ANY TYPE (LIQUID, GEL, PASTE, ETC.), PER 1 ML |
| A9268 |
PROGRAMMER FOR TRANSIENT, ORALLY INGESTED CAPSULE |
| A9269 |
PROGRAMABLE, TRANSIENT, ORALLY INGESTED CAPSULE, FOR USE WITH EXTERNAL PROGRAMMER, PER MONTH |
| K1036 |
SUPPLIES AND ACCESSORIES (E.G., TRANSDUCER) FOR LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE, PER MONTH |
| V2526 |
CONTACT LENS, HYDROPHILIC, WITH BLUE-VIOLET FILTER, PER LENS |
Narrative Changes
Urological Supplies
| Code |
Old Narrative |
New Narrative |
| A4344 |
INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE, EACH |
INDWELLING CATHETER; FOLEY TYPE, TWO-WAY, ALL SILICONE OR POLYURETHANE, EACH |
Miscellaneous
| Code |
Old Narrative |
New Narrative |
| K1004 |
LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE FOR HOME USE, INCLUDES ALL COMPONENTS AND ACCESSORIES |
LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE FOR HOME USE |
| K1028 |
POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE FOR THE REDUCTION OF SNORING AND OBSTRUCTIVE SLEEP APNEA, CONTROLLED BY PHONE APPLICATION |
POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY PHONE APPLICATION |
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 page for email, FAX, or postal mail information.
Revision History
| Date |
Update |
| 09/29/2023 |
Published on PDAC website |