Learn More About 2022 HCPCS Level II Code Changes

Learn More About 2022 HCPCS Level II Code Changes

In first quarter 2022, the HCPCS Level II code set will get a refresh with several new, revised, and deleted codes. According to the Centers for Medicare & Medicaid Services (CMS), there are:

  • 155 new codes,
  • 63 revised codes, and
  • 48 deleted codes.

Medical coders and billers: Familiarize yourself now with these code changes so you’re ready when your organization’s coding and billing software updates Jan. 1, 2022.

Understand What These New Codes Report

The following codes were created per the request of third-party stakeholders after going through CMS’ standard HCPCS Level II code application process.

Q4199 Cygnus matrix, per square centimeter

This is a new code for Cygnus™ Matrix, which is for “use as a wound covering or barrier in surgical, orthopedic, ophthalmic and wound applications,” according to the 2021 HCPCS Application Summary (summary).

J9061 Injection, amivantamab-vmjw, 2 mg

This code will replace HCPCS Level II code C9083, which is being discontinued on Dec. 31. This code reports RYBREVANT®, which is indicated for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC). It is supplied as a single-dose 350 mg/7 mL (50 mg/mL) vial, according to the summary.

J9021 Injection, asparaginase, recombinant, (rylaze), 0.1 mg

Rylaze™ is indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL).

A9595 Piflufolastat f-18, diagnostic, 1 millicurie

Piflufolastat F-18 is also known as PYLARIFY® and is for use as a positron emission tomography imaging agent.

J9272 Injection, dostarlimab-gxly, 10 mg

This HCPCS Level II code will replace C9082, which is being discontinued on Dec. 31. Code J9272 reports Jemperli, which “is a programmed death receptor-1 (PD-1)-blocking antibody indicated for the treatment of adult patients with mismatch repair deficient (dMMR) recurrent or advanced endometrial cancer,” according to the summary.

J1952 Leuprolide injectable, camcevi, 1 mg

This is a new code to report Camcevi®, which “is indicated for the treatment of adult patients with advanced prostate cancer,” the applicant states in the summary.

J0172 Injection, aducanumab-avwa, 2 mg

This code is being added to identify ADUHELM® for the treatment of Alzheimer’s disease.

Q2055 Idecabtagene vicleucel, up to 460 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

This HCPCS Level II code was created to identify ABECMA®, which is a B-cell maturation antigen (BCMA)-directed genetically modified autologous cell immunotherapy. “ABECMA is indicated for the treatment of adult patients with relapsed or refractory multiple myeloma after four or more prior lines of therapy,” per the summary.

Pay Attention to Effective Dates

Two new HCPCS Level II codes included in the first quarter 2022 update have a delated effective date.

Effective April 1, 2021:

G0465 Autologous platelet rich plasma (prp) for diabetic chronic wounds/ulcers, using an FDA-cleared device (includes administration, dressings, phlebotomy, centrifugation, and all other preparatory procedures, per treatment)

G0460 Autologous platelet rich plasma for non-diabetic chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment

Remember: The HCPCS Level II code set only identifies categories of items and services. The existence or absence of a HCPCS Level II code does not mean an item or service is covered or non-covered under Medicare. Check your payer policies and the National Correct Coding Initiative file for coverage indictors.

Source: CMS, 2021 HCPCS Application Summary Third Quarter 2021

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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.

7 Responses to “Learn More About 2022 HCPCS Level II Code Changes”

  1. Dilcia Diaz says:

    Is there a billing Guide for J0172? If so, where can I obtain?

  2. Renee Dustman says:

    Best to check the payer’s policy. Here’s a link to Cigna’s, as example, https://static.cigna.com/assets/chcp/pdf/coveragePolicies/pharmacy/ip_0200_coveragepositioncriteria_aducanumab.pdf

  3. April says:

    Good morning. We were using 0191T for the aqueous stent – has that changed? Our surgeons occasionally do this procedure when a cataract (66984) is done. Looking for further documentation. Thank you

  4. Renee Dustman says:

    CPT® deleted 0191T. CPT® added 66989 and 66991 for cataract removal with insertion of an anterior segment aqueous drainage device. CPT® also added 0671T for insertion of the drainage device without cataract removal. Effective date of this deletion: January 1, 2022.

  5. Patricia A says:

    Is there a HCPCS for disability strollers

  6. Renee Dustman says:

    you might try Pediatric Wheelchairs HCPCS Code range E1229-E1239

  7. Kimberly Masupha says:

    Can Cabenuva 400/600 mg kit and Cabenuva 600/900 mg kit be coded with the J0741 code or does it need the J3490 code?