Releases › HCPCS Level II April 2023

HCPCS Level II April 2023

Effective 2023-04-01 to 2023-06-30. 7,831 codes in the release.

46added
10revised
8removed

Codes added 46

CodeDescription
A2019 Kerecis omega3 marigen shield, per square centimeter
A2020 Ac5 advanced wound system (ac5)
A2021 Neomatrix, per square centimeter
A4341 Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
A4342 Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each
A4560 Neuromuscular electrical stimulator (nmes), disposable, replacement only
A6590 External urinary catheters; disposable, with wicking material, for use with suction pump, per month
A6591 External urinary catheter; non-disposable, for use with suction pump, per month
A7049 Expiratory positive airway pressure intranasal resistance valve
C9145 Injection, aprepitant, (aponvie), 1 mg
C9146 Injection, mirvetuximab soravtansine-gynx, 1 mg
C9147 Injection, tremelimumab-actl, 1 mg
C9148 Injection, teclistamab-cqyv, 0.5 mg
C9149 Injection, teplizumab-mzwv, 5 mcg
E0677 Non-pneumatic sequential compression garment, trunk
E0711 Upper extremity medical tubing/lines enclosure or covering device, restricts elbow range of motion
E1905 Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software
J0208 Injection, sodium thiosulfate, 100 mg
J0218 Injection, olipudase alfa-rpcp, 1 mg
J0612 Injection, calcium gluconate (fresenius kabi), per 10 mg
J0613 Injection, calcium gluconate (wg critical care), per 10 mg
J1411 Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
J1449 Injection, eflapegrastim-xnst, 0.1 mg
J1747 Injection, spesolimab-sbzo, 1 mg
J2403 Chloroprocaine hcl ophthalmic, 3% gel, 1 mg
J9196 Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg
J9294 Injection, pemetrexed (hospira) not therapeutically equivalent to j9305, 10 mg
J9296 Injection, pemetrexed (accord) not therapeutically equivalent to j9305, 10 mg
J9297 Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg
JK One month supply or less of drug or biological
JL Three month supply of drug or biological
K1035 Molecular diagnostic test reader, nonprescription self-administered and self-collected use, fda approved, authorized or cleared
L8678 Electrical stimulator supplies (external) for use with implantable neurostimulator, per month
M0010 Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services
Q4265 Neostim tl, per square centimeter
Q4266 Neostim membrane, per square centimeter
Q4267 Neostim dl, per square centimeter
Q4268 Surgraft ft, per square centimeter
Q4269 Surgraft xt, per square centimeter
Q4270 Complete sl, per square centimeter
Q4271 Complete ft, per square centimeter
Q5127 Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg
Q5128 Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg
Q5129 Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg
Q5130 Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg
S9563 Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem

Descriptions revised 10

CodeWas, and is now
A4628 Oropharyngeal suction catheter, each Oral and/or oropharyngeal suction catheter, each
J1954 Injection, leuprolide acetate for depot suspension (lutrate), 7.5 mg Injection, leuprolide acetate for depot suspension (cipla), 7.5 mg
J9314 Injection, pemetrexed (teva) not therapeutically equivalent to J9305, 10 mg Injection, pemetrexed (teva) not therapeutically equivalent to j9305, 10 mg
K1019 Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
LU Fractionated payment of car-t therapy Fractionated payment
Q5108 Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
Q5111 Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
Q5120 Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg
Q5122 Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg
S9562 Home injectable therapy, palivizumab, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem Home injectable therapy, palivizumab or other monoclonal antibody for rsv, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem

Terminated 8

CodeDescription
C1834 Pressure sensor system, includes all components (e.g., introducer, sensor), intramuscular (implantable), excludes mobile (wireless) software application
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source
G2024 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source
J0610 Injection, calcium gluconate (fresenius kabi), per 10 ml
J0611 Injection, calcium gluconate (wg critical care), per 10 ml
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2