2023 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 2023. 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, 2023.

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, 2023. 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. There were no narrative changes in this cycle.

E0490 E0491 L1681 L5991 A9156 A9268 A9269 K1036 V2526 A4344 K1004 K1028

Added Codes

Enteral Nutrition

Code Narrative
B4148 ENTERAL FEEDING SUPPLY KIT; ELASTOMERIC CONTROL FED, PER DAY, INCLUDES BUT NOT LIMITED TO FEEDING/FLUSHING SYRINGE, ADMINISTRATION SET TUBING, DRESSINGS, TAPE

 

Neuromuscular Electrical Stimulation (NMES)

Code Narrative
E0490 POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY HARDWARE REMOTE
E0491 ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, USED IN CONJUNCTION WITH THE POWER SOURCE AND CONTROL ELECTRONICS UNIT, CONTROLLED BY HARDWARE REMOTE, 90-DAY SUPPLY

 

Lower Limb Orthotic

Code Narrative
L1681 HIP ORTHOSIS, BILATERAL HIP JOINTS AND THIGH CUFFS, ADJUSTABLE FLEXION, EXTENSION, ABDUCTION CONTROL OF HIP JOINT, POSTOPERATIVE HIP ABDUCTION TYPE, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE

 

Lower Limb Prosthetic

Code Narrative
L5991 ADDITION TO LOWER EXTREMITY PROSTHESES, OSSEOINTEGRATED EXTERNAL PROSTHETIC CONNECTOR

 

Miscellaneous

Code Narrative
A9156 ORAL MUCOADHESIVE, ANY TYPE (LIQUID, GEL, PASTE, ETC.), PER 1 ML
A9268 PROGRAMMER FOR TRANSIENT, ORALLY INGESTED CAPSULE
A9269 PROGRAMABLE, TRANSIENT, ORALLY INGESTED CAPSULE, FOR USE WITH EXTERNAL PROGRAMMER, PER MONTH
K1036 SUPPLIES AND ACCESSORIES (E.G., TRANSDUCER) FOR LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE, PER MONTH
V2526 CONTACT LENS, HYDROPHILIC, WITH BLUE-VIOLET FILTER, PER LENS

 

Narrative Changes

Urological Supplies

Code Old Narrative New Narrative
A4344 INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE, EACH INDWELLING CATHETER; FOLEY TYPE, TWO-WAY, ALL SILICONE OR POLYURETHANE, EACH

 

Miscellaneous

Code Old Narrative New Narrative
K1004 LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE FOR HOME USE, INCLUDES ALL COMPONENTS AND ACCESSORIES LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE FOR HOME USE
K1028 POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE FOR THE REDUCTION OF SNORING AND OBSTRUCTIVE SLEEP APNEA, CONTROLLED BY PHONE APPLICATION POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY PHONE APPLICATION

 

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 page for email, FAX, or postal mail information.

Publication History

Date of Change Description
09/28/23 Originally Published

 

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