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 |
