What’s in Store for 2011 HCPCS Level II Codes

The 2011 HCPCS Level II code changes the Centers for Medicare & Medicaid Services (CMS) posted Nov. 2 include 147 new codes and modifiers and more than 286 deleted codes. Changes include the addition of pass-through codes, a large number of G procedures/professional services codes, and many injectable drugs, among others.

With the exception of temporary codes, HCPCS Level II alphanumeric procedure and modifier codes are updated annually Jan. 1. Codes are updated throughout the year, but the alphanumeric HCPCS Level II file is uploaded to the CMS website on an annual basis. As a result, temporary coding changes or Medicare administrative, coverage, or pricing data changes occurring outside of the annual update process may not be reflected in the released file and are usually noted in Program Memoranda (PM) to Medicare carriers and fiscal intermediaries (FIs).

Deleted Codes

The majority of deletions are in the G codes between G0430 and G8521. Among them are procedures/professional services including: diabetic, heart failure and coronary artery disease services, osteoporosis and hearing assessment, urinary incontinence, e-prescribing system codes, intraocular pressure, end-stage renal disease (ESRD), “patient not documented to have …,” cancer, influenza screening, and tobacco codes, and so on.

C code deletions include injections codes C9255, C9256, C9258-C9269, and C9271.

Discontinued E codes are E0220, E0230, and E0238.

J codes see many injection code additions and deletions in the code range J0558 – J0580 for penicillin G benzathine injection codes. There are several deleted cyclophosphamide and gamma globulin, intramuscular codes with the addition of injection, immune globulin codes.

Many skin protection wheelchair seat cushion K codes are deleted, as well.

Additions

Briefly, here are some notable additions to the 2011 list of covered HCPCS Level II codes:

  • Q4117-Q4121, which address matrices used to support healing of burns or ulcers
  • Q flu vaccination codes for patients 3 years and older
  • Skilled services codes (G0162-G0164)
  • G tobacco/smoking-related codes
  • Risk-adjusted functional status change residual score G codes
  • G blood pressure codes

Description Changes

There have been changes in the long descriptions of skin graft codes Q4101-Q4116, pain assessment and acceptable EHR system G codes. The short description of wheelchair code K0669 has been changed, as well.

These updates are only part of the changes in store for the new year. To view all HCPCS Level II code changes for 2011, the Alphanumeric Index, and Table of Drugs go to the CMS website.

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10 Responses to “What’s in Store for 2011 HCPCS Level II Codes”

  1. IRENE SNYDER says:

    WOULD IT BENEFIT MYSELF TO PURCHASE THE 2011 NEW CODE BOOKS IN THE SPRING? JAN-MAY AND ALSO WHERE MAY I PURCHASE STUDY BOOKS SO THAT I MAY TAKE PRACTICE TESTS TO PREPARE MYSELF FOR THE EXAM? THANK YOU FOR YOUR TIME.

    SINCERELY, IRENE SNYDER 330-733-9464

  2. JOHN ENGEL says:

    HCPC Q4109 for Tissuemend is being deleted 1/1/11 – has anyone found any guidance for a new code for this product?

    Thanks

  3. Louise Ashburn says:

    Irene, the most helpful item I would recommend is the 2009 “Step by Step Medical Coding” text by Carol J. Buck, along with the most recent code books you can borrow. If you get a job your employer will usually provide the books so having your own set might be an unnecessary expense. On the other hand, if you buy your own set, you can write in them, make your own tabs, and be really familiar with them when you take the exam. A medical dictionary is great too, but you can’t take it with you into the exam.
    I didn’t find workbooks or practice tests all that helpful, myself…do all the exercises in the textbook, read the guidelines and all the ancillary material in the front and back of your code books so you know where to find data about medicare, modifiers, who publishes the codes and how often they are updated, and think about your strategy when you take the test (look up everything? Do every question in order or do the quick ones first?) and think speed and you should come out all right. And never forget that as a coder you will always code to the highest degree of specificity: not just a close code, but the one that accurately replicates what is in the medical record. Good luck!

  4. Louise Ashburn says:

    Oh, and Irene, look in the AAPC forums…that’s where this Q & A rightfully belong. :-)

  5. ivette says:

    Please i would like to know what code should i used to substitute j0560.
    thank you

  6. Marianne Harper says:

    I have heard that the D codes (dental) have been removed from HCPCS effective 1-1-11. Is that true?

  7. spring cook says:

    Can someone help me please? I am looking for the new HCPCs code for the e-prescribing. It looks like G8443 and G8445 were deleted for 2011 and I am unclear what to use in their place. I would appreciate any help someone could give me.

    Thanks

  8. Peggy says:

    The 2011 list of G codes found @ CMS website are showing the G8443 and G8445 as being valid.
    G8443-ALL prescriptions during encounter were generated using qualified e-prescribing system.

    G8445-NO prescriptions were generated during encounter. Provider does have access to qualified e-prescribing system.

    You must use G8644 at least on one claim prior to June 30, 2011 if the provider does not have prescribing privileges at all. Then payments will not be reduced hereafter.

  9. JULIA says:

    what CPT code I should use from 1/1 /2011 for injections of Bicillin CR 1 200 000 unit IM ,and Bicillin LA 1 200 000 units IM.Thank You for information and making my life happy again.Julia the coder in medical office.

  10. TINA says:

    DOES ANYYONE KNOW THE REPLACEMENT CPT CODE FOR J0559
    PENICILLIN G. BENZATHINE 2500
    THANK YOU

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