Few April 1 Changes to HCPCS Level II

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  • January 16, 2015
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Changes to HCPCS Level II codes and modifiers are as expected as the sunrise, but changes slated to become effective April 1, 2015 are surprisingly few, especially after the nearly 550 changes, effective January 1.
The Centers for Medicare and Medicaid Services (CMS) added two modifiers and one code; making the April update relatively easy for coders, billers, and data managers:

  • JF            Compounded drug
  • EX           Expatriate beneficiary
  • Q9975    Injection, Factor VIII, FC fusion protein (recombinant), per IU

Although special coverage instructions apply to Q9975, the modifiers are subject to carrier judgment. Check with your Medicare Administrative Contractor (MAC)  for details, in your area.

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Brad Ericson
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Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

No Responses to “Few April 1 Changes to HCPCS Level II”

  1. Susan Garcia says:

    Mr Erickson , I Susan need your Assistance about
    Modifiers for Caloptima Ccn( Considered same as Medical.
    I have been searching, for Modifier for 76856 ( pelvic Ultasound)- including 99214.
    I have billed with 99214 & 76856-26
    99214 & 76856-25
    Denied not right Modifier, please help!
    Thank – You
    Miss Susan Garcia