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):
| Code | Change | Description |
| A4271 | ADD | Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per month |
| A4438 | ADD | Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each |
| A4564 | ADD | Pessary, disposable, any type |
| A4593 | ADD | Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller |
| A4594 | ADD | Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each |
| A9293 | ADD | Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer) |
| C9159 | DISCONTINUED | Injection, prothrombin complex concentrate (human), balfaxar, per i.u. of factor ix activity |
| C9160 | DISCONTINUED | Injection, daxibotulinumtoxina-lanm, 1 unit |
| C9161 | DISCONTINUED | Injection, aflibercept hd, 1 mg |
| C9162 | DISCONTINUED | Injection, avacincaptad pegol, 0.1 mg |
| C9163 | DISCONTINUED | Injection, talquetamab-tgvs, 0.25 mg |
| C9164 | DISCONTINUED | Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg) |
| C9165 | DISCONTINUED | Injection, elranatamab-bcmm, 1 mg |
| C9166 | ADD | Injection, secukinumab, intravenous, 1 mg |
| C9167 | ADD | Injection, adamts13, recombinant-krhn, 10 iu |
| C9168 | ADD | Injection, mirikizumab-mrkz, 1 mg |
| C9796 | ADD | Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa [sis]) |
| C9797 | ADD | Vascular 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 |
| E0152 | ADD | Walker, battery powered, wheeled, folding, adjustable or fixed height |
| E0468 | ADD | Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions |
| E0738 | ADD | Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories |
| E0739 | ADD | Rehab system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors |
| E2104 | ADD | Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge |
| E2298 | ADD | Complex rehabilitative power wheelchair accessory, power seat elevation system, any type |
| E2300 | DISCONTINUED | Wheelchair accessory, power seat elevation system, any type |
| G0138 | ADD | Intravenous 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 |
| J0177 | ADD | Injection, aflibercept hd, 1 mg |
| J0209 | ADD | Injection, sodium thiosulfate (hope), 100 mg |
| J0576 | DISCONTINUED | Injection, buprenorphine extended-release (brixadi), 1 mg |
| J0577 | ADD | Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy |
| J0578 | ADD | Injection, buprenorphine extended-release (brixadi), greater than 7 days and up to 28 days of therapy |
| J0589 | ADD | Injection, daxibotulinumtoxina-lanm, 1 unit |
| J0651 | ADD | Injection, levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650, 10 mcg |
| J0652 | ADD | Injection, levothyroxine sodium (hikma) not therapeutically equivalent to j0650, 10 mcg |
| J1010 | ADD | Injection, methylprednisolone acetate, 1 mg |
| J1020 | DISCONTINUED | Injection, methylprednisolone acetate, 20 mg |
| J1030 | DISCONTINUED | Injection, methylprednisolone acetate, 40 mg |
| J1040 | DISCONTINUED | Injection, methylprednisolone acetate, 80 mg |
| J1202 | ADD | Miglustat, oral, 65 mg |
| J1203 | ADD | Injection, cipaglucosidase alfa-atga, 5 mg |
| J1323 | ADD | Injection, elranatamab-bcmm, 1 mg |
| J1434 | ADD | Injection, fosaprepitant (focinvez), 1 mg |
| J1840 | DISCONTINUED | Injection, kanamycin sulfate, up to 500 mg |
| J1850 | DISCONTINUED | Injection, kanamycin sulfate, up to 75 mg |
| J2277 | ADD | Injection, motixafortide, 0.25 mg |
| J2782 | ADD | Injection, avacincaptad pegol, 0.1 mg |
| J2801 | ADD | Injection, risperidone (rykindo), 0.5 mg |
| J2919 | ADD | Injection, methylprednisolone sodium succinate, 5 mg |
| J2920 | DISCONTINUED | Injection, methylprednisolone sodium succinate, up to 40 mg |
| J2930 | DISCONTINUED | Injection, methylprednisolone sodium succinate, up to 125 mg |
| J3055 | ADD | Injection, talquetamab-tgvs, 0.25 mg |
| J3424 | ADD | Injection, hydroxocobalamin, intravenous, 25 mg |
| J7165 | ADD | Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity |
| J7354 | ADD | Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg) |
| J9070 | DISCONTINUED | Cyclophosphamide, 100 mg |
| J9073 | ADD | Injection, cyclophosphamide (ingenus), 5 mg |
| J9074 | ADD | Injection, cyclophosphamide (sandoz), 5 mg |
| J9075 | ADD | Injection, cyclophosphamide, not otherwise specified, 5 mg |
| J9248 | ADD | Injection, melphalan (hepzato), 1 mg |
| J9249 | ADD | Injection, melphalan (apotex), 1 mg |
| J9250 | DISCONTINUED | Methotrexate sodium, 5 mg |
| K1037 | ADD | Docking station for use with oral device/appliance used to reduce upper airway collapsibility |
| L1320 | ADD | Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated |
| L5783 | ADD | Addition to lower extremity, user adjustable, mechanical, residual limb volume management system |
| L5841 | ADD | Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control |
| Q4244 | DISCONTINUED | Procenta, per 200 mg |
| Q4305 | ADD | American amnion ac tri-layer, per square centimeter |
| Q4306 | ADD | American amnion ac, per square centimeter |
| Q4307 | ADD | American amnion, per square centimeter |
| Q4308 | ADD | Sanopellis, per square centimeter |
| Q4309 | ADD | Via matrix, per square centimeter |
| Q4310 | ADD | Procenta, per 100 mg |
| Q5133 | ADD | Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg |
| Q5134 | ADD | Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg |
| S4988 | ADD | Penile contracture device, manual, greater than 3 lbs traction force |
| S9002 | ADD | Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device |
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