HCPCS Level II Code Changes in Effect July 1

HCPCS Level II Code Changes in Effect July 1

The Centers for Medicare & Medicaid Services (CMS) released on May 13 the July 2020 quarterly update to the HCPCS Level II file. There are 61 added codes to describe healthcare equipment and supplies not identified by CPT® codes, as well as nine deleted codes and three revised codes.

The July update to the HCPCS Level II code set is effective July 1, 2020 (except where noted). Medicare coverage and payment determinations for HCPCS Level II codes without specific Medicare coverage or payment indicators are left to the discretion of the Medicare Administrative Contractors processing the claims.

Added Codes

HCPCS Level IILONG DESCRIPTION
C1748Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable)
C1849Skin substitute, synthetic, resorbable, per square centimeter
C9059Injection, meloxicam, 1 mg
C9061Injection, teprotumumab-trbw, 10 mg
C9063Injection, eptinezumab-jjmr, 1 mg
C9122Mometasone furoate sinus implant, 10 micrograms (sinuva)
C9759Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when performed
C9760Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right and left heart catheterization, transeptal puncture, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study
C9762Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging
C9763Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging
C9764Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed
C9765Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed
C9766Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed
C9767Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed
C9803Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source
G2025Payment for a telehealth distant site service furnished by a rural health clinic (RHC) or federally qualified health center (FQHC) only
G2170Percutaneous arteriovenous fistula creation (AVF), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performed
G2171Percutaneous arteriovenous fistula creation (AVF), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed
J0223Injection, givosiran, 0.5 mg
J0591Injection, deoxycholic acid, 1 mg
J0691Injection, lefamulin, 1 mg
J0742Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg
J0791Injection, crizanlizumab-tmca, 0.5 mg
J0896Injection, luspatercept-aamt, 0.25 mg
J1201Injection, cetirizine hydrochloride, 0.5 mg
J1429Injection, golodirsen, 10 mg
J1558Injection, immune globulin (Xembify), 100 mg
J3399Injection, Onasemnogene abeparvovec-xioi, per treatment, up to 5×1015 vector genomes
J7169Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg
J7204Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu
J7333Hyaluronan or derivative, visco-3, for intra-articular injection, per dose
J9177Injection, enfortumab vedotin-ejfv, 0.25 mg
J9198Injection, gemcitabine hydrochloride, (infugem), 100 mg
J9246Injection, melphalan (evomela), 1 mg
J9358Injection, fam-trastuzumab deruxtecan-nxki, 1 mg
Q4227Amniocore, per square centimeter
Q4228Bionextpatch, per square centimeter
Q4229Cogenex amniotic membrane, per square centimeter
Q4230Cogenex flowable amnion, per 0.5 cc
Q4231Corplex P, per cc
Q4232Corplex, per square centimeter
Q4233Surfactor or nudyn, per 0.5 cc
Q4234Xcellerate, per square centimeter
Q4235Amniorepair or altiply, per square centimeter
Q4236Carepatch, per square centimeter
Q4237Cryo-cord, per square centimeter
Q4238Derm-maxx, per square centimeter
Q4239Amnio-maxx or amnio-maxx lite, per square centimeter
Q4240Corecyte, for topical use only, per 0.5 cc
Q4241Polycyte, for topical use only, per 0.5 cc
Q4242Amniocyte plus, per 0.5 cc
Q4244Procenta, per 200 mg
Q4245Amniotext, per cc
Q4246Coretext or protext, per cc
Q4247Amniotext patch, per square centimeter
Q4248Dermacyte amniotic membrane allograft, per square centimeter
Q5119*Injection, Rituximab-pvvr, biosimilar, (Ruxience), 10 mg
Q5120*Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg
Q5121Injection, infliximab-axxq, biosimilar, (avsola), 10 mg
U0003Infectious 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
U00042019-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

Discontinued Codes

HCPCS Level IILONG DESCRIPTION
C9041Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg
C9053Injection, crizanlizumab-tmca, 1 mg
C9054Injection, lefamulin (xenleta), 1 mg
C9056Injection, givosiran, 0.5 mg
C9057Injection, cetirizine hydrochloride, 1 mg
C9058Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg
C9754Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed)
C9755Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed
J9199Injection, gemcitabine hydrochloride (infugem), 200 mg

Long Description Change

HCPCS Level IILONG DESCRIPTION
J7321Hyaluronan or derivative, hyalgan or supartz or visco-3, for intra-articular injection, per dose
J9245Injection, melphalan hydrochloride, not otherwise specified, 50 mg
Q4176Neopatch or therion, per square centimeter

*CMS will issue separate instructions regarding dates of service for Medicare.

See “HCPCS Code Application Summaries and CMS Decisions for Q1 2020” for information about the new codes (indications, etc.)

The HCPCS Level II quarterly update is available for download from the CMS website.

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Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 20 years experience in print production and content management. Follow her on Twitter @dustman_aapc.

5 Responses to “HCPCS Level II Code Changes in Effect July 1”

  1. Jennifer Hart says:

    I wanted to know how are they coding the Covid-19 in the ICD-10-CM?

  2. hkomorn md says:

    what is transcatheter intraoperative blood vessel microinfusion therapy

  3. Paula W says:

    I’m trying to locate education on billing an TESI and RFA with a J code for medication. I’ve notice billing being used with 64635 +J1040. The physician is doing this in office.

  4. Courtney says:

    Hello, does anyone know if C9764-C9767 can be billed by a physician? Or is it strictly a facility code?

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