HCPCS 2013 Code Changes

Orthopedic Print Friendly and PDF
New
Code Description
E0670 Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk
E2378 Power wheelchair component, actuator, replacement only
G0456 Negative pressure wound therapy, (e. G. Vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters
G0457 Negative pressure wound therapy, (e. G. Vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters
G8938 Bmi is calculated, but patient not eligible for follow-up plan
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting
G8981 Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
G8982 Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8983 Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
G8984 Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals
G8985 Carrying, moving & handling objects functional limitation, projected goal status, at therapy episode outset and at reporting intervals
G8986 Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8989 Self care functional limitation, discharge status, at discharge from therapy or to end reporting
G8990 Other physical or occupational primary functional limitation, current status, at therapy episode outset and at reporting intervals
G8991 Other physical or occupational primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8992 Other physical or occupational primary functional limitation, discharge status, at discharge from therapy or to end reporting
G8993 Other physical or occupational subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
G8994 Other physical or occupational subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
G8995 Other physical or occupational subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
G8996 Swallowing functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals
G8997 Swallowing functional limitation, projected goal status, at initial therapy treatment/outset and at discharge from therapy
G8998 Swallowing functional limitation, discharge status, at discharge from therapy/end of reporting on limitation
G8999 Motor speech functional limitation, current status at time of initial therapy treatment/episode outset and reporting intervals
G9157 Transesophageal doppler use for cardiac monitoring
J1741 Injection, ibuprofen, 100 mg
L5859 Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)
Q4132 Grafix core, per square centimeter
Q4133 Grafix prime, per square centimeter
Q4134 Hmatrix, per square centimeter
Q4135 Mediskin, per square centimeter
Q4136 Ez-derm, per square centimeter
G9233 All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
G9234 I intend to report the total knee replacement measures group
K0901 Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
K0902 Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
C9743 Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)
E1012 Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each
G9502 Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
J7328 Hyaluronan or derivative, Gel-Syn, for intra-articular injection, 0.1 mg
Q9980 Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg
A4467 Belt, strap, sleeve, garment, or covering, any type
A4553 Non-disposable underpads, all sizes
A9285 Inversion/eversion correction device
G9719 Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9721 Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9769 Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months
G9780 Patients who have a diagnosis of rhabdomyolysis
J1130 Injection, diclofenac sodium, 0.5 mg
J7320 Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
J7322 Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg
L1851 Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
L1852 Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
E0953 Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each
E0954 Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot
G9941 Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
G9942 Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
G9943 Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months ( 6 - 20 weeks) postoperatively
G9944 Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
G9945 Patient had cancer, fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis
G9946 Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
G9947 Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
G9948 Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
G9949 Leg pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
J1428 Injection, eteplirsen, 10 mg
L3761 Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf
L7700 Gasket or seal, for use with prosthetic socket insert, any type, each
Q4177 Floweramnioflo, 0.1 cc
Q4178 Floweramniopatch, per square centimeter
Q4179 Flowerderm, per square centimeter
Q4180 Revita, per square centimeter
Q4181 Amnio wound, per square centimeter
Q4182 Transcyte, per square centimeter
Revised
CodeDescriptor
L1906 Ankle foot orthosis, multiligamentus ankle support, prefabricated, off-the-shelf
K0017 Detachable, adjustable height armrest, base, replacement only, each
K0018 Detachable, adjustable height armrest, upper portion, replacement only, each
E0627 Seat lift mechanism, electric, any type
E0629 Seat lift mechanism, non-electric, any type
E0967 Manual wheelchair accessory, hand rim with projections, any type, replacement only, each
E0995 Wheelchair accessory, calf rest/pad, replacement only, each
E2206 Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each
E2220 Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each
E2221 Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each
E2222 Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each
E2224 Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each
G8649 Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's status survey near discharge, not appropriate
G8653 Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete follow up status survey near discharge, patient not appropriate
G8655 Risk-adjusted functional status change residual score for the foot or ankle successfully calculated and the score was equal to zero (0) or greater than zero ( > 0)
G8656 Risk-adjusted functional status change residual score for the foot or ankle successfully calculated and the score was less than zero (< 0)
G8657 Risk-adjusted functional status change residual scores for the foot or ankle not measured because the patient did not complete foto's status survey near discharge, patient not appropriate
G8658 Risk-adjusted functional status change residual scores for the foot or ankle not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8659 Risk-adjusted functional status change residual score for the lumbar impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
G8660 Risk-adjusted functional status change residual score for the lumbar impairment successfully calculated and the score was less than zero (< 0)
G8661 Risk-adjusted functional status change residual scores for the lumbar impairment not measured because the patient did not complete foto's status survey near discharge, patient not appropriate
G8662 Risk-adjusted functional status change residual scores for the lumbar impairment not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
G8665 Risk-adjusted functional status change residual scores for the shoulder not measured because the patient did not complete foto's functional status survey near discharge, patient not appropriate
G8669 Risk-adjusted functional status change residual scores for the elbow, wrist or hand not measured because the patient did not complete foto's functional follow up status survey near discharge, patient not appropriate
G8671 Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
G8672 Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment successfully calculated and the score was less than zero (< 0)
G8673 Risk-adjusted functional status change residual scores for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment not measured because the patient did not complete foto's functional follow up status survey near discharge, patient not appropriate
G8674 Risk-adjusted functional status change residual scores for the neck, cranium, mandible, thoracic spine, ribs, or other general orthopaedic impairment not measured because the patient did not complete foto's functional intake on admission and/or follow up status survey near discharge, reason not given
J1745 Injection, infliximab, excludes biosimilar, 10 mg
K0019 Arm pad, replacement only, each
K0037 High mount flip-up footrest, replacement only, each
K0042 Standard size footplate, replacement only, each
K0043 Footrest, lower extension tube, replacement only, each
K0044 Footrest, upper hanger bracket, replacement only, each
K0045 Footrest, complete assembly, replacement only, each
K0046 Elevating legrest, lower extension tube, replacement only, each
K0047 Elevating legrest, upper hanger bracket, replacement only, each
K0050 Ratchet assembly, replacement only
K0051 Cam release assembly, footrest or legrest, replacement only, each
K0052 Swingaway, detachable footrests, replacement only, each
K0069 Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each
K0071 Front caster assembly, complete, with pneumatic tire, replacement only, each
K0072 Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
K0077 Front caster assembly, complete, with solid tire, replacement only, each
K0098 Drive belt for power wheelchair, replacement only
K0552 Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
L1906 Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose
L3760 Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Deleted
CodeDescriptor
C9366 Epifix, per square centimeter
C9368 Grafix core, per square centimeter
C9369 Grafix prime, per square centimeter
G8871 Patient not receiving a first course of anti-TNF therapy
S2360 Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; cervical
S2361 Each additional cervical vertebral body (list separately in addition to code for primary procedure)
S8262 Mandibular orc repositioning device, each
C9471 Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg
C9743 Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)
E0628 Separate seat lift mechanism for use with patient owned furniture-electric
G8490 I intend to report the rheumatoid arthritis (ra) measures group
G8499 All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient
G8634 Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis
G8868 Patients receiving a first course of anti-tnf therapy
G9233 All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
G9234 I intend to report the total knee replacement measures group
J0760 Injection, colchicine, per 1 mg
K0901 Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
K0902 Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Q9980 Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg
C9484 Injection, eteplirsen, 10 mg
C9485 Injection, olaratumab, 10 mg
C9489 Injection, nusinersen, 0.1 mg
G0364 Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service