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October 1, 2026

2026 HCPCS Code Update – October Edition – Correct Coding

Joint DME MAC and PDAC Publication

The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for October 2026. The tables contain only HCPCS codes applicable to items within Medicare DME MAC jurisdiction. There may be other HCPCS code changes for items under the jurisdiction of other Medicare contractors. Consult those contractors for information regarding HCPCS codes within their areas of responsibility.

All HCPCS code changes are effective for claims with dates of service on or after October 1, 2026.

Code Change Categories

Added Codes/Modifiers: Identifies newly created codes and modifiers. Listing of a code in the tables does not necessarily indicate coverage. Refer to the applicable Local Coverage Determination for information regarding Medicare reimbursement requirements.
Discontinued Codes/Deleted Modifiers: Identifies codes and modifiers discontinued or deleted in the new cycle. These codes and modifiers continue to be valid for Medicare claims with dates of service either on or before September 30, 2026. There is no grace period for submission of a discontinued code/modifier for claims with dates of service after its effective end date. If there is a direct crosswalk for a discontinued/deleted code or modifier, the crosswalk code will be displayed in a table.
Narrative Changes: Identifies changes in the narrative descriptor for an existing code or modifier.

Added Codes

Ankle-Foot/Knee-Ankle-Foot Orthosis
Code	Narrative
L1972	ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL WITH ANKLE JOINT, WITH OR WITHOUT DORSIFLEXION ASSIST, PREFABRICATED, OFF-THE SHELF

External Infusion Pumps
Code	Narrative
A4228	SUPPLIES FOR MAINTENANCE OF NON-INSULIN, DEVICE-DRUG COMBINATION INFUSION CATHETER, PER WEEK
E0788	AMBULATORY INFUSION PUMP, SPECIFIC DEVICE-DRUG COMBINATION, SINGLE OR MULTIPLE CHANNELS, ELECTRIC OR BATTERY OPERATED, WITH ADMINISTRATIVE EQUIPMENT, WORN BY PATIENT
J9191	INJECTION, FLUOROURACIL (AVYXA), 10 MG
J9192	INJECTION, FLUOROURACIL, 10 MG

Immunosuppressive Drugs
Code	Narrative
J7524	MYCOPHENOLATE MOFETIL, ORAL, 5 MG
J7529	MYCOPHENOLATE MOFETIL, FOR SUSPENSION, ORAL, 5 MG
J7530	MYCOPHENOLATE MOFETIL (MYHIBBIN), ORAL SUSPENSION, 5 MG
J7531	PREDNISOLONE SODIUM PHOSPHATE, ORALLY DISINTEGRATING TABLET, 1 MG

Miscellaneous
Code	Narrative
A6614	SUPPLIES AND ACCESSORIES FOR USE WITH AN EXTERNAL OCULAR NEGATIVE PRESSURE PUMP, ANY TYPE, PER MONTH
E2403	EXTERNAL OCULAR NEGATIVE PRESSURE PUMP, ELECTRIC
J0643	INJECTION, LEUCOVORIN CALCIUM, NOT OTHERWISE SPECIFIED, 1 MG
J0644	INJECTION, LEUCOVORIN CALCIUM (AVYXA), 1 MG
J0871	INJECTION, DAPTOMYCIN (ENDO), NOT THERAPEUTICALLY EQUIVALENT TO J0878, 1 MG
J1757	INJECTION, TIVIDENOFUSP ALFA-EKNM, 1 MG
J1818	INJECTION, PEGZILARGINASE-NBLN, 0.05 MG
J1946	INJECTION, FUROSEMIDE (LASIX ONYU), 1 MG
J1947	INJECTION, FUROSEMIDE (FUROSCIX), 1 MG
J1957	INJECTION, LEVETIRACETAM, 5 MG
J1958	INJECTION, LEVETIRACETAM IN SODIUM CHLORIDE, 5 MG
J3268	INJECTION, DELAFLOXACIN, 1 MG
J3406	INJECTION, OMIDUBICEL-ONLV, PER THERAPEUTIC DOSE
J7526	INJECTION, MYCOPHENOLATE MOFETIL, 5 MG
J9066	INJECTION, BENDAMUSTINE HYDROCHLORIDE (AVYXA), 1 MG
J9186	INJECTION, ETOPOSIDE (AVYXA), 1 MG
J9187	INJECTION, ETOPOSIDE, 1 MG
J9362	INJECTION, TRABECTEDIN, 0.01 MG
L1330	THORACIC ORTHOSIS, STERNAL AND/OR STERNOCOSTAL COMPRESSION, MAY INCLUDE ANTERIOR AND/OR POSTERIOR PADS, PANELS, WITH OR WITHOUT FRAME, PREFABRICATED, OFF THE SHELF
Q5172	INJECTION, FILGRASTIM-LAHA (FILKRI), BIOSIMILAR, 1 MICROGRAM

Discontinued Codes

External Infusion Pumps
Code	Narrative
J9190	INJECTION, FLUOROURACIL, 500 MG

Immunosuppressive Drugs
Code	Narrative
J7514	MYCOPHENOLATE MOFETIL (MYHIBBIN), ORAL SUSPENSION, 100 MG
J7517	MYCOPHENOLATE MOFETIL, ORAL, 250 MG
J7528	MYCOPHENOLATE MOFETIL, FOR SUSPENSION, ORAL, 100 MG

Miscellaneous
Code	Narrative
J0640	INJECTION, LEUCOVORIN CALCIUM, PER 50 MG
J1941	INJECTION, FUROSEMIDE (FUROSCIX), 20 MG
J1953	INJECTION, LEVETIRACETAM, 10 MG
J7519	INJECTION, MYCOPHENOLATE MOFETIL, 10 MG
J9181	INJECTION, ETOPOSIDE, 10 MG
J9352	INJECTION, TRABECTEDIN, 0.1 MG

Narrative Changes

Ankle-Foot/Knee-Ankle-Foot Orthosis
Code	Old Narrative	New Narrative
L1971	ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL WITH ANKLE JOINT, WITH OR WITHOUT DORSIFLEXION ASSIST, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT	ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL WITH ANKLE JOINT, WITH OR WITHOUT DORSIFLEXION ASSIST, PREFABRICATED, ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE

External Breast Prostheses
Code	Old Narrative	New Narrative
L8030	BREAST PROSTHESIS, SILICONE OR EQUAL, WITHOUT INTEGRAL ADHESIVE	BREAST PROSTHESIS, SILICONE OR EQUAL, WITHOUT INTEGRAL ADHESIVE, ANY TYPE
L8031	BREAST PROSTHESIS, SILICONE OR EQUAL, WITH INTEGRAL ADHESIVE	BREAST PROSTHESIS, SILICONE OR EQUAL, WITH INTEGRAL ADHESIVE, ANY TYPE
L8035	CUSTOM BREAST PROSTHESIS, POST MASTECTOMY, MOLDED TO PATIENT MODEL	CUSTOM BREAST PROSTHESIS, POST MASTECTOMY, MOLDED TO PATIENT MODEL, ANY TYPE

Miscellaneous
Code	Old Narrative	New Narrative
J3300	INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1 MG	INJECTION, TRIAMCINOLONE ACETONIDE (TRIESENCE), PRESERVATIVE FREE, 1 MG
J9033	INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG	INJECTION, BENDAMUSTINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 1 MG

Refer to the Centers for Medicare and Medicaid Services (CMS) website to download a full listing of HCPCS code additions, revisions, deletions, etc. in an excel file.

For questions about correct coding or products not listed on the DMECS Product Classification List (PCL), contact the PDAC HCPCS Helpline at (877) 735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday. You may also visit the PDAC website to chat with a representative or select the Contact Us button at the top of the PDAC website for email, FAX, or postal mail information.

Publication History
October 1, 2026	Originally Published