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December 26, 2012

The 2013 HCPCS Updates – New, Verbiage Changes, and Discontinued HCPCS Codes

The 2013 HCPCS File has been published. There are several additions, verbiage updates, and discontinued codes. The following lists are categorized by the changes that will become effective January 1, 2013. Each list identifies specific changes to level II Healthcare Common Procedure Coding System (HCPCS) codes for 2013.

The first listing contains the added HCPCS codes that will take effect on 01/01/2013. Please keep in mind, the appearance of an added HCPCS code is not an indication of coverage by the DME MAC.

HCPCS DESCRIPTION
A4435 Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
E0670 Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk
E2378 Power wheelchair component, actuator, replacement only
J0178 Injection, aflibercept, 1 mg
J0485 Injection, belatacept, 1 mg
J0716 Injection, centruroides immune f(ab)2, up to 120 milligrams
J0890 Injection, peginesatide, 0. 1 mg (for esrd on dialysis)
J1050 Injection, medroxyprogesterone acetate, 1 mg
J1741 Injection, ibuprofen, 100 mg
J1744 Injection, icatibant, 1 mg
J2212 Injection, methylnaltrexone, 0. 1 mg
J7178 Injection, human fibrinogen concentrate, 1 mg
J7315 Mitomycin, opthalmic, 0. 2 mg
J7527 Everolimus, oral, 0. 25 mg
J9002 Injection, doxorubicin hydrochloride, liposomal, doxil, 10 mg
J9019 Injection, asparaginase (erwinaze), 1,000 iu
J9042 Injection, brentuximab vedotin, 1 mg
L5859 Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)
L7902 Tension ring, for vacuum erection device, any type, replacement only, each
L8605 Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies

The next category is the verbiage changes. The listing below contains the HCPCS code with description changes and is as follows:

HCPCS DESCRIPTION
A6021 Collagen dressing, sterile, size 16 sq. In. Or less, each
A6022 Collagen dressing, sterile, size more than 16 sq. In. But less than or equal to 48 sq. In., each
A6023 Collagen dressing, sterile, size more than 48 sq. In., each
E0300 Pediatric crib, hospital grade, fully enclosed, with or without top enclosure
E1020 Residual limb support system for wheelchair, any type
E2368 Power wheelchair component, drive wheel motor, replacement only
E2369 Power wheelchair component, drive wheel gear box, replacement only
E2370 Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only
J1561 Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e. G. Liquid), 500 mg
J1569 Injection, immune globulin, (gammagard liquid), non-lyophilized, (e. G. Liquid) 500 mg
J9020 Injection, asparaginase, not otherwise specified, 10,000 units
J9280 Injection, mitomycin, 5 mg
L5972 All lower extremity prostheses, foot, flexible keel
L8000 Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type
L8001 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type
L8002 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type

In addition, there are discontinued HCPCS Codes. Some of the discontinued HCPCS codes have been cross-walked to other HCPCS codes. However, not all discontinued HCPCS Codes will have a cross-walked code. The listing below contains discontinued HCPCS codes along with the cross-walked HCPCS code (if applicable).

HCPCS DESCRIPTION DISCONTINUE DATE CROSSWALK HCPCS CODE
J1051 Injection, medroxyprogesterone acetate, 50 mg 12/31/2012  
J1055 Injection, medroxyprogesterone acetate for contraceptive use, 150 mg 12/31/2012  
J1056 Injection, medroxyprogesterone acetate / estradiol cypionate, 5mg / 25mg 12/31/2012  
J8561 Everolimus, oral, 0.25 mg 12/31/2012 J7527
Q2045 Injection, human fibrinogen concentrate, 1 mg 12/31/2012 J7178
Q2046 Injection, aflibercept, 1 mg 12/31/2012 J0178
Q2047 Injection, peginesatide, 0. 1 mg (for esrd on dialysis) 12/31/2012 J0890
Q2048 Injection, doxorubicin hydrochloride, liposomal, doxil, 10 mg 12/31/2012 J9002
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