HCPCS Level II Code Changes in Effect July 1
- By Renee Dustman
- In Coding
- June 3, 2020
- 7 Comments
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 II | LONG DESCRIPTION |
|---|---|
| C1748 | Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable) |
| C1849 | Skin substitute, synthetic, resorbable, per square centimeter |
| C9059 | Injection, meloxicam, 1 mg |
| C9061 | Injection, teprotumumab-trbw, 10 mg |
| C9063 | Injection, eptinezumab-jjmr, 1 mg |
| C9122 | Mometasone furoate sinus implant, 10 micrograms (sinuva) |
| C9759 | Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when performed |
| C9760 | Non-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 |
| C9762 | Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging |
| C9763 | Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging |
| C9764 | Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed |
| C9765 | Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed |
| C9766 | Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed |
| C9767 | Revascularization, 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 |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (RHC) or federally qualified health center (FQHC) only |
| G2170 | Percutaneous 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 |
| G2171 | Percutaneous 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 |
| J0223 | Injection, givosiran, 0.5 mg |
| J0591 | Injection, deoxycholic acid, 1 mg |
| J0691 | Injection, lefamulin, 1 mg |
| J0742 | Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg |
| J0791 | Injection, crizanlizumab-tmca, 0.5 mg |
| J0896 | Injection, luspatercept-aamt, 0.25 mg |
| J1201 | Injection, cetirizine hydrochloride, 0.5 mg |
| J1429 | Injection, golodirsen, 10 mg |
| J1558 | Injection, immune globulin (Xembify), 100 mg |
| J3399 | Injection, Onasemnogene abeparvovec-xioi, per treatment, up to 5×1015 vector genomes |
| J7169 | Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg |
| J7204 | Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu |
| J7333 | Hyaluronan or derivative, visco-3, for intra-articular injection, per dose |
| J9177 | Injection, enfortumab vedotin-ejfv, 0.25 mg |
| J9198 | Injection, gemcitabine hydrochloride, (infugem), 100 mg |
| J9246 | Injection, melphalan (evomela), 1 mg |
| J9358 | Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
| Q4227 | Amniocore, per square centimeter |
| Q4228 | Bionextpatch, per square centimeter |
| Q4229 | Cogenex amniotic membrane, per square centimeter |
| Q4230 | Cogenex flowable amnion, per 0.5 cc |
| Q4231 | Corplex P, per cc |
| Q4232 | Corplex, per square centimeter |
| Q4233 | Surfactor or nudyn, per 0.5 cc |
| Q4234 | Xcellerate, per square centimeter |
| Q4235 | Amniorepair or altiply, per square centimeter |
| Q4236 | Carepatch, per square centimeter |
| Q4237 | Cryo-cord, per square centimeter |
| Q4238 | Derm-maxx, per square centimeter |
| Q4239 | Amnio-maxx or amnio-maxx lite, per square centimeter |
| Q4240 | Corecyte, for topical use only, per 0.5 cc |
| Q4241 | Polycyte, for topical use only, per 0.5 cc |
| Q4242 | Amniocyte plus, per 0.5 cc |
| Q4244 | Procenta, per 200 mg |
| Q4245 | Amniotext, per cc |
| Q4246 | Coretext or protext, per cc |
| Q4247 | Amniotext patch, per square centimeter |
| Q4248 | Dermacyte amniotic membrane allograft, per square centimeter |
| Q5119* | Injection, Rituximab-pvvr, biosimilar, (Ruxience), 10 mg |
| Q5120* | Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg |
| 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 |
Discontinued Codes
| HCPCS Level II | LONG DESCRIPTION |
|---|---|
| C9041 | Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg |
| C9053 | Injection, crizanlizumab-tmca, 1 mg |
| C9054 | Injection, lefamulin (xenleta), 1 mg |
| C9056 | Injection, givosiran, 0.5 mg |
| C9057 | Injection, cetirizine hydrochloride, 1 mg |
| C9058 | Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg |
| C9754 | Creation 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) |
| C9755 | Creation 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 |
| J9199 | Injection, gemcitabine hydrochloride (infugem), 200 mg |
Long Description Change
| HCPCS Level II | LONG DESCRIPTION |
|---|---|
| J7321 | Hyaluronan or derivative, hyalgan or supartz |
| J9245 | Injection, melphalan hydrochloride, not otherwise specified, 50 mg |
| Q4176 | Neopatch 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.
Managing Editor at AAPC
Renee Dustman, BS, AAPC MACRA Proficient, is managing editor - content & editorial at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 30 years' experience in journalistic reporting, print production, graphic design, and content management. Follow her on Twitter @dustman_aapc.
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I wanted to know how are they coding the Covid-19 in the ICD-10-CM?
https://www.aapc.com/blog/49883-coronavirus-what-every-medical-coder-needs-to-know/
what is transcatheter intraoperative blood vessel microinfusion therapy
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.
Hello, does anyone know if C9764-C9767 can be billed by a physician? Or is it strictly a facility code?
hi, I have the same question as Courtney had on July 6, 2020
hcpcs C9764-C9767 gets submitted on the UB form- facility or also on the cms 1500- professional bill?
paid under OPPS/ASC