RETIRED - 2022 HCPCS Code Update - April Edition - Correct Coding

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.

Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Joint DME MAC and PDAC Publication
Posted March 31, 2022

The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2022. 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 April 1, 2022.

Code Change Categories

  • Added Codes/Modifiers: Identifies newly created codes and modifiers. Listing of a code in the tables does not necessarily indicate coverage (Emphasis added). 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 March 31, 2022. 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.

Added Codes

Glucose Monitors

Code Narrative
A4238 SUPPLY ALLOWANCE FOR ADJUNCTIVE CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES, 1 MONTH SUPPLY = 1 UNIT OF SERVICE
E2102 ADJUNCTIVE CONTINUOUS GLUCOSE MONITOR OR RECEIVER

 

Refractive Lens

Code Narrative
V2525 CONTACT LENS, HYDROPHILIC, DUAL FOCUS, PER LENS

 

Miscellaneous

Code Narrative
A9291 PRESCRIPTION DIGITAL BEHAVIORAL THERAPY, FDA CLEARED, PER COURSE OF TREATMENT
K1028 POWER SOURCE AND CONTROL ELECTRONICS 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
K1029 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
K1030 EXTERNAL RECHARGING SYSTEM FOR BATTERY (INTERNAL) FOR USE WITH IMPLANTED CARDIAC CONTRACTILITY MODULATION GENERATOR, REPLACEMENT ONLY
K1031 NON-PNEUMATIC COMPRESSION CONTROLLER WITHOUT CALIBRATED GRADIENT PRESSURE
K1032 NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, FULL LEG
K1033 NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, HALF LEG

 

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
03/31/22 Originally Published
04/14/22 Retired due to removal of HCPCS codes A9291 and K1030 from Miscellaneous "Added Codes" table, as these HCPCS codes are not DME MAC jurisdiction (as of the HCPCS codes effective date April 1, 2022). See Revised article published 04/14/2022

 

Last Updated Dec 10 , 2023