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    Veronica Bradley
    Veronica Bradley, CPC, CPMA

    Medical codes are an integral part of revenue cycle capture. Healthcare Common Procedure Coding System (HCPCS) is a code set used to identify durable medical supplies, pharmaceuticals and procedures. The Centers for Medicare & Medicaid (CMS) is responsible for revising and updating the HCPCS codes each quarter:

    • 1st Quarter: Jan. 1 – March 31
    • 2nd Quarter: April 1 – June 30
    • 3rd Quarter: July 1 – Sept. 30
    • 4th Quarter: Oct. 1 – Dec. 31.

    Medical coders and billers must evaluate the published updates as CMS releases each quarter to ensure reimbursement, reduce denials, and aware of financial altercations that can impact reimbursement from payers.

    CMS has released 1st Quarter 2024 codes with many revisions (updated April 17):

    A4271ADDIntegrated lancing and blood sample testing cartridges for home blood glucose monitor, per month
    A4438ADDAdhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
    A4564ADDPessary, disposable, any type
    A4593ADDNeuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller
    A4594ADDNeuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each
    A9293ADDFertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)
    C9159DISCONTINUEDInjection, prothrombin complex concentrate (human), balfaxar, per i.u. of factor ix activity
    C9160DISCONTINUEDInjection, daxibotulinumtoxina-lanm, 1 unit
    C9161DISCONTINUEDInjection, aflibercept hd, 1 mg
    C9162DISCONTINUEDInjection, avacincaptad pegol, 0.1 mg
    C9163DISCONTINUEDInjection, talquetamab-tgvs, 0.25 mg
    C9164DISCONTINUEDCantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
    C9165DISCONTINUEDInjection, elranatamab-bcmm, 1 mg
    C9166ADDInjection, secukinumab, intravenous, 1 mg
    C9167ADDInjection, adamts13, recombinant-krhn, 10 iu
    C9168ADDInjection, mirikizumab-mrkz, 1 mg
    C9796ADDRepair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa [sis])
    C9797ADDVascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction
    E0152ADDWalker, battery powered, wheeled, folding, adjustable or fixed height
    E0468ADDHome ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions
    E0738ADDUpper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories
    E0739ADDRehab system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors
    E2104ADDHome blood glucose monitor for use with integrated lancing/blood sample testing cartridge
    E2298ADDComplex rehabilitative power wheelchair accessory, power seat elevation system, any type
    E2300DISCONTINUEDWheelchair accessory, power seat elevation system, any type
    G0138ADDIntravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga
    J0177ADDInjection, aflibercept hd, 1 mg
    J0209ADDInjection, sodium thiosulfate (hope), 100 mg
    J0576DISCONTINUEDInjection, buprenorphine extended-release (brixadi), 1 mg
    J0577ADDInjection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
    J0578ADDInjection, buprenorphine extended-release (brixadi), greater than 7 days and up to 28 days of therapy
    J0589ADDInjection, daxibotulinumtoxina-lanm, 1 unit
    J0651ADDInjection, levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650, 10 mcg
    J0652ADDInjection, levothyroxine sodium (hikma) not therapeutically equivalent to j0650, 10 mcg
    J1010ADDInjection, methylprednisolone acetate, 1 mg
    J1020DISCONTINUEDInjection, methylprednisolone acetate, 20 mg
    J1030DISCONTINUEDInjection, methylprednisolone acetate, 40 mg
    J1040DISCONTINUEDInjection, methylprednisolone acetate, 80 mg
    J1202ADDMiglustat, oral, 65 mg
    J1203ADDInjection, cipaglucosidase alfa-atga, 5 mg
    J1323ADDInjection, elranatamab-bcmm, 1 mg
    J1434ADDInjection, fosaprepitant (focinvez), 1 mg
    J1840DISCONTINUEDInjection, kanamycin sulfate, up to 500 mg
    J1850DISCONTINUEDInjection, kanamycin sulfate, up to 75 mg
    J2277ADDInjection, motixafortide, 0.25 mg
    J2782ADDInjection, avacincaptad pegol, 0.1 mg
    J2801ADDInjection, risperidone (rykindo), 0.5 mg
    J2919ADDInjection, methylprednisolone sodium succinate, 5 mg
    J2920DISCONTINUEDInjection, methylprednisolone sodium succinate, up to 40 mg
    J2930DISCONTINUEDInjection, methylprednisolone sodium succinate, up to 125 mg
    J3055ADDInjection, talquetamab-tgvs, 0.25 mg
    J3424ADDInjection, hydroxocobalamin, intravenous, 25 mg
    J7165ADDInjection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
    J7354ADDCantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
    J9070DISCONTINUEDCyclophosphamide, 100 mg
    J9073ADDInjection, cyclophosphamide (ingenus), 5 mg
    J9074ADDInjection, cyclophosphamide (sandoz), 5 mg
    J9075ADDInjection, cyclophosphamide, not otherwise specified, 5 mg
    J9248ADDInjection, melphalan (hepzato), 1 mg
    J9249ADDInjection, melphalan (apotex), 1 mg
    J9250DISCONTINUEDMethotrexate sodium, 5 mg
    K1037ADDDocking station for use with oral device/appliance used to reduce upper airway collapsibility
    L1320ADDThoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
    L5783ADDAddition to lower extremity, user adjustable, mechanical, residual limb volume management system
    L5841ADDAddition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control
    Q4244DISCONTINUEDProcenta, per 200 mg
    Q4305ADDAmerican amnion ac tri-layer, per square centimeter
    Q4306ADDAmerican amnion ac, per square centimeter
    Q4307ADDAmerican amnion, per square centimeter
    Q4308ADDSanopellis, per square centimeter
    Q4309ADDVia matrix, per square centimeter
    Q4310ADDProcenta, per 100 mg
    Q5133ADDInjection, tocilizumab-bavi (tofidence), biosimilar, 1 mg
    Q5134ADDInjection, natalizumab-sztn (tyruko), biosimilar, 1 mg
    S4988ADDPenile contracture device, manual, greater than 3 lbs traction force
    S9002ADDIntra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device

    Veronica Bradley

    Written By

    Veronica Bradley, CPC, CPMA

    Veronica Bradley, CPC, CPMA, has more than 20 years’ experience in medical coding and auditing in various specialties. She is also well-versed hierarchical condition category and risk adjustment coding. Other areas of expertise include E/M, procedural coding, Medicare reimbursement and other critical factors in coding and auditing. Veronica has worked in private practice, group practices, academic school of medicine and hospitals. Veronica received a bachelor’s degree in health information management and a minor in healthcare administration from Regis University in Denver.

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