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November 27, 2023

January 2024 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes and Modifiers

The following information is based on the January 2024 Healthcare Common Procedure Coding System (HCPCS) file. There are several updates that will be effective in January 2024. Please keep in mind that the appearance of a HCPCS code is not an indication of coverage by the DME MAC.

This following list contains added HCPCS codes that will be effective in January 2024.

HCPCS DESCRIPTION Effective Date
A4287 Disposable collection and storage bag for breast milk, any size, any type, each 01/01/2024
A4457 Enema tube, with or without adapter, any type, replacement only, each 01/01/2024
A4468 Exsufflation belt, includes all supplies and accessories 01/01/2024
A4540 Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm 01/01/2024
A4541 Monthly supplies for use of device coded at e0733 01/01/2024
A4542 Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist 01/01/2024
A6520 Gradient compression garment, glove, padded, for nighttime use, each 01/01/2024
A6521 Gradient compression garment, glove, padded, for nighttime use, custom, each 01/01/2024
A6522 Gradient compression garment, arm, padded, for nighttime use, each 01/01/2024
A6523 Gradient compression garment, arm, padded, for nighttime use, custom, each 01/01/2024
A6524 Gradient compression garment, lower leg and foot, padded, for nighttime use, each 01/01/2024
A6525 Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each 01/01/2024
A6526 Gradient compression garment, full leg and foot, padded, for nighttime use, each 01/01/2024
A6527 Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each 01/01/2024
A6528 Gradient compression garment, bra, for nighttime use, each 01/01/2024
A6529 Gradient compression garment, bra, for nighttime use, custom, each 01/01/2024
A6552 Gradient compression stocking, below knee, 30-40 mmhg, each 01/01/2024
A6553 Gradient compression stocking, below knee, 30-40 mmhg, custom, each 01/01/2024
A6554 Gradient compression stocking, below knee, 40 mmhg or greater, each 01/01/2024
A6555 Gradient compression stocking, below knee, 40 mmhg or greater, custom, each 01/01/2024
A6556 Gradient compression stocking, thigh length, 18-30 mmhg, custom, each 01/01/2024
A6557 Gradient compression stocking, thigh length, 30-40 mmhg, custom, each 01/01/2024
A6558 Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each 01/01/2024
A6559 Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each 01/01/2024
A6560 Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each 01/01/2024
A6561 Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each 01/01/2024
A6562 Gradient compression stocking, waist length, 18-30 mmhg, custom, each 01/01/2024
A6563 Gradient compression stocking, waist length, 30-40 mmhg, custom, each 01/01/2024
A6564 Gradient compression stocking, waist length, 40 mmhg or greater, custom, each 01/01/2024
A6565 Gradient compression gauntlet, custom, each 01/01/2024
A6566 Gradient compression garment, neck/head, each 01/01/2024
A6567 Gradient compression garment, neck/head, custom, each 01/01/2024
A6568 Gradient compression garment, torso and shoulder, each 01/01/2024
A6569 Gradient compression garment, torso/shoulder, custom, each 01/01/2024
A6570 Gradient compression garment, genital region, each 01/01/2024
A6571 Gradient compression garment, genital region, custom, each 01/01/2024
A6572 Gradient compression garment, toe caps, each 01/01/2024
A6573 Gradient compression garment, toe caps, custom, each 01/01/2024
A6574 Gradient compression arm sleeve and glove combination, custom, each 01/01/2024
A6575 Gradient compression arm sleeve and glove combination, each 01/01/2024
A6576 Gradient compression arm sleeve, custom, medium weight, each 01/01/2024
A6577 Gradient compression arm sleeve, custom, heavy weight, each 01/01/2024
A6578 Gradient compression arm sleeve, each 01/01/2024
A6579 Gradient compression glove, custom, medium weight, each 01/01/2024
A6580 Gradient compression glove, custom, heavy weight, each 01/01/2024
A6581 Gradient compression glove, each 01/01/2024
A6582 Gradient compression gauntlet, each 01/01/2024
A6583 Gradient compression wrap with adjustable straps, below knee, 30-50 mmhg, each 01/01/2024
A6584 Gradient compression wrap with adjustable straps, not otherwise specified 01/01/2024
A6585 Gradient pressure wrap with adjustable straps, above knee, each 01/01/2024
A6586 Gradient pressure wrap with adjustable straps, full leg, each 01/01/2024
A6587 Gradient pressure wrap with adjustable straps, foot, each 01/01/2024
A6588 Gradient pressure wrap with adjustable straps, arm, each 01/01/2024
A6589 Gradient pressure wrap with adjustable straps, bra, each 01/01/2024
A6593 Accessory for gradient compression garment or wrap with adjustable straps, non-otherwise specified 01/01/2024
A6594 Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each 01/01/2024
A6595 Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each 01/01/2024
A6596 Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each 01/01/2024
A6597 Gradient compression bandage roll, elastic long stretch, linear yard, any width, each 01/01/2024
A6598 Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each 01/01/2024
A6599 Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each 01/01/2024
A6600 Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each 01/01/2024
A6601 Gradient compression bandaging supply, high density foam pad, any size or shape, each 01/01/2024
A6602 Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each 01/01/2024
A6603 Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each 01/01/2024
A6604 Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each 01/01/2024
A6605 Gradient compression bandaging supply, padded foam, per linear yard, any width, each 01/01/2024
A6606 Gradient compression bandaging supply, padded textile, per linear yard, any width, each 01/01/2024
A6607 Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each 01/01/2024
A6608 Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each 01/01/2024
A6609 Gradient compression bandaging supply, not otherwise specified 01/01/2024
A6610 Gradient compression stocking, below knee, 18-30 mmhg, custom, each 01/01/2024
A7023 Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical 01/01/2024
E0492 Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application 01/01/2024
E0493 Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply 01/01/2024
E0530 Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type 01/01/2024
E0678 Non-pneumatic sequential compression garment, full leg 01/01/2024
E0679 Non-pneumatic sequential compression garment, half leg 01/01/2024
E0680 Non-pneumatic compression controller with sequential calibrated gradient pressure 01/01/2024
E0681 Non-pneumatic compression controller without calibrated gradient pressure 01/01/2024
E0682 Non-pneumatic sequential compression garment, full arm 01/01/2024
E0732 Cranial electrotherapy stimulation (ces) system, any type 01/01/2024
E0733 Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve 01/01/2024
E0734 External upper limb tremor stimulator of the peripheral nerves of the wrist 01/01/2024
E0735 Non-invasive vagus nerve stimulator 01/01/2024
E1301 Whirlpool tub, walk-in, portable 01/01/2024
E2001 Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system 01/01/2024
E3000 Speech volume modulation system, any type, including all components and accessories 01/01/2024
J0184 Injection, amisulpride, 1 mg 01/01/2024
J0217 Injection, velmanase alfa-tycv, 1 mg 01/01/2024
J0391 Injection, artesunate, 1 mg 01/01/2024
J0402 Injection, aripiprazole (abilify asimtufii), 1 mg 01/01/2024
J0576 Injection, buprenorphine extended-release (brixadi), 1 mg 01/01/2024
J0688 Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg 01/01/2024
J0750 Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) 01/02/2024
J0751 Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) 01/02/2024
J0799 Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified 01/02/2024
J0873 Injection, daptomycin (xellia) not therapeutically equivalent to j0878, 1 mg 01/01/2024
J1105 Dexmedetomidine, oral, 1 mcg 01/01/2024
J1246 Injection, dinutuximab, 0.1 mg 01/01/2024
J1304 Injection, tofersen, 1 mg 01/01/2024
J1412 Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes 01/01/2024
J1413 Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose 01/01/2024
J1596 Injection, glycopyrrolate, 0.1 mg 01/01/2024
J1939 Injection, bumetanide, 0.5 mg 01/01/2024
J2404 Injection, nicardipine, 0.1 mg 01/01/2024
J2508 Injection, pegunigalsidase alfa-iwxj, 1 mg 01/01/2024
J2679 Injection, fluphenazine hcl, 1.25 mg 01/01/2024
J2799 Injection, risperidone (uzedy), 1 mg 01/01/2024
J3401 Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml 01/01/2024
J3425 Injection, hydroxocobalamin, 10 mcg 01/01/2024
J9052 Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg 01/01/2024
J9072 Injection, cyclophosphamide, (dr. reddy's), 5 mg 01/01/2024
J9172 Injection, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg 01/01/2024
J9255 Injection, methotrexate (accord) not therapeutically equivalent to j9250 and j9260, 50 mg 01/01/2024
J9258 Injection, paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264, 1 mg 01/01/2024
J9286 Injection, glofitamab-gxbm, 2.5 mg 01/01/2024
J9321 Injection, epcoritamab-bysp, 0.16 mg 01/01/2024
J9324 Injection, pemetrexed (pemrydi rtu), 10 mg 01/01/2024
J9333 Injection, rozanolixizumab-noli, 1 mg 01/01/2024
J9334 Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc 01/01/2024
L3161 Foot, adductus positioning device, adjustable 01/01/2024
L5615 Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control 01/01/2024
L5926 Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type 01/01/2024
Q0516 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 30-days 01/02/2024
Q0517 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 60-days 01/02/2024
Q0518 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 90-days 01/02/2024
Q5132 Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg 01/01/2024

The following HCPCS codes have description/verbiage changes that will be effective in January 2024.

HCPCS DESCRIPTION Effective Date
A6531 Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each 01/01/2024
A6532 Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each 01/01/2024
A6535 Gradient compression stocking, thigh length, 40 mmhg or greater, each 01/01/2024
A6538 Gradient compression stocking, full length/chap style, 40 mmhg or greater, each 01/01/2024
A6541 Gradient compression stocking, waist length, 40 mmhg or greater, each 01/01/2024
A6545 Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each 01/01/2024
A6549 Gradient compression garment, not otherwise specified 01/01/2024
J0739 Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) 01/02/2024
Q2052 Services, supplies and accessories used in the home for the administration of intravenous immune globulin (ivig) 01/01/2024

The following listing contains discontinued HCPCS codes, along with the cross-walked HCPCS codes (if applicable). Please note, not all discontinued HCPCS codes will have a cross-walked HCPCS code.

HCPCS DISCONTINUE DATE CROSSWALK HCPCS CODE
J9160 12/31/2023  
K1001 12/31/2023 E0530
K1002 12/31/2023 E0732
K1003 12/31/2023 E1301
K1005 12/31/2023 A4287
K1006 12/31/2023 E2001
K1009 12/31/2023 E3000
K1013 12/31/2023 A4457
K1014 12/31/2023 L5615
K1015 12/31/2023 L3161
K1016 12/31/2023 E0733
K1017 12/31/2023 A4541
K1018 12/31/2023 E0734
K1019 12/31/2023 A4542
K1020 12/31/2023 E0735
K1021 12/31/2023 A4468
K1022 12/31/2023 L5926
K1023 12/31/2023 A4540
K1024 12/31/2023 E0680
K1025 12/31/2023 E0682
K1026 12/31/2023 A7023
K1028 12/31/2023 E0492
K1029 12/31/2023 E0493
K1031 12/31/2023 E0681
K1032 12/31/2023 E0678
K1033 12/31/2023 E0679

The following listing contains HCPCS codes with changes to the CMS Pricing Categories effective in January 2024.

HCPCS New Pricing Category Effective Date
A6530 Lymphedema Compression Treatment Items 01/01/2024
A6533 Lymphedema Compression Treatment Items 01/01/2024
A6534 Lymphedema Compression Treatment Items 01/01/2024
A6535 Lymphedema Compression Treatment Items 01/01/2024
A6536 Lymphedema Compression Treatment Items 01/01/2024
A6537 Lymphedema Compression Treatment Items 01/01/2024
A6538 Lymphedema Compression Treatment Items 01/01/2024
A6539 Lymphedema Compression Treatment Items 01/01/2024
A6540 Lymphedema Compression Treatment Items 01/01/2024
A6541 Lymphedema Compression Treatment Items 01/01/2024
A6549 Lymphedema Compression Treatment Items 01/01/2024
K1007 Orthotics, prosthetics, prosthetic devices & vision services 01/01/2024
L8701 Orthotics, prosthetics, prosthetic devices & vision services 01/01/2024
L8702 Orthotics, prosthetics, prosthetic devices & vision services 01/01/2024

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