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November 17, 2015

The 2016 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes

The 2016 Healthcare Common Procedure Coding System (HCPCS) File has been published. There are several additions, revisions, and discontinued HCPCS codes. The changes are effective January 1, 2016. Please keep in mind, the appearance of a HCPCS code is not an indication of coverage by the DME MAC.

The first listing contains the added HCPCS Codes that will take effect on January 01, 2016.

HCPCS Description
A4337 Incontinence supply, rectal insert, any type, each
E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)
E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)
E1012 Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each
J0202 Injection, alemtuzumab, 1 mg
J0596 Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units
J0695 Injection, ceftolozane 50 mg and tazobactam 25 mg
J0714 Injection, ceftazidime and avibactam, 0.5 g/0.125 g
J0875 Injection, dalbavancin, 5mg
J1447 Injection, tbo-filgrastim, 1 microgram
J1575 Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
J1833 Injection, isavuconazonium, 1 mg
J2407 Injection, oritavancin, 10 mg
J2502 Injection, pasireotide long acting, 1 mg
J2547 Injection, peramivir, 1 mg
J2860 Injection, siltuximab, 10 mg
J3090 Injection, tedizolid phosphate, 1 mg
J3380 Injection, vedolizumab, 1 mg
J7121 5% dextrose in lactated ringers infusion, up to 1000 cc
J7340 Carbidopa 5 mg/levodopa 20 mg enteral suspension
J7503 Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
J7512 Prednisone, immediate release or delayed release, oral, 1 mg
J7999 Compounded drug, not otherwise classified
J8655 Netupitant 300 mg and palonosetron 0.5 mg
J9032 Injection, belinostat, 10 mg
J9039 Injection, blinatumomab, 1 microgram
J9271 Injection, pembrolizumab, 1 mg
J9299 Injection, nivolumab, 1 mg
J9308 Injection, ramucirumab, 5 mg
Q5101 Injection, filgrastim (g-csf), biosimilar, 1 microgram


The listing of HCPCS Codes with description/verbiage changes that will take effect January 01, 2016 is as follows:

HCPCS Description
B5000 Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix
B5100 Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix
B5200 Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix
J0571 Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
J0572 Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
J0573 Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 3.1 to 6 mg
J0574 Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine
J0575 Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine
J1442 Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram
J7508 Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
K0017 Detachable, adjustable height armrest, base, replacement only, each
K0018 Detachable, adjustable height armrest, upper portion, replacement only, each
L1902 Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf
L1904 Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated


The last listing contains discontinued HCPCS Codes along with the cross-walked HCPCS Code (if applicable). However, not all discontinued HCPCS Codes will have a cross-walked HCPCS Code. The list is as follows:

HCPCS Discontinue Date Crosswalk HCPCS Code
A7011 12/31/2015  
E0450 12/31/2015 E0465
E0460 12/31/2015 E0466
E0461 12/31/2015 E0466
E0463 12/31/2015 E0465
E0464 12/31/2015 E0466
J0886 12/31/2015  
J1446 12/31/2015  
J7506 12/31/2015  
J9010 12/31/2015 J0202
Q9977 12/31/2015 J7999
Q9978 12/31/2015 J8655
Q9979 12/31/2015 J0202
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