2024 HCPCS Code Update - January Edition - Correct Coding - JA DME
2024 HCPCS Code Update - January Edition - Correct Coding
Joint DME MAC and PDAC Publication
Posted January 4, 2024
The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for January 2024. 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 January 1, 2024.
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 or correct coding and billing publication 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 December 31, 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 to a new code 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
Lower Limb Prostheses
| Code | Narrative |
|---|---|
| L5615 | ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, 4 BAR LINKAGE OR MULTIAXIAL, FLUID SWING AND STANCE PHASE CONTROL |
| L5926 | ADDITION TO LOWER EXTREMITY PROSTHESIS, ENDOSKELETAL, KNEE DISARTICULATION, ABOVE KNEE, HIP DISARTICULATION, POSITIONAL ROTATION UNIT, ANY TYPE |
Lymphedema Compression Treatment Items
| Code | Narrative |
|---|---|
| A6520 | GRADIENT COMPRESSION GARMENT, GLOVE, PADDED, FOR NIGHTTIME USE, EACH |
| A6521 | GRADIENT COMPRESSION GARMENT, GLOVE, PADDED, FOR NIGHTTIME USE, CUSTOM, EACH |
| A6522 | GRADIENT COMPRESSION GARMENT, ARM, PADDED, FOR NIGHTTIME USE, EACH |
| A6523 | GRADIENT COMPRESSION GARMENT, ARM, PADDED, FOR NIGHTTIME USE, CUSTOM, EACH |
| A6524 | GRADIENT COMPRESSION GARMENT, LOWER LEG AND FOOT, PADDED, FOR NIGHTTIME USE, EACH |
| A6525 | GRADIENT COMPRESSION GARMENT, LOWER LEG AND FOOT, PADDED, FOR NIGHTTIME USE, CUSTOM, EACH |
| A6526 | GRADIENT COMPRESSION GARMENT, FULL LEG AND FOOT, PADDED, FOR NIGHTTIME USE, EACH |
| A6527 | GRADIENT COMPRESSION GARMENT, FULL LEG AND FOOT, PADDED, FOR NIGHTTIME USE, CUSTOM, EACH |
| A6528 | GRADIENT COMPRESSION GARMENT, BRA, FOR NIGHTTIME USE, EACH |
| A6529 | GRADIENT COMPRESSION GARMENT, BRA, FOR NIGHTTIME USE, CUSTOM, EACH |
| A6552 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, EACH |
| A6553 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, CUSTOM, EACH |
| A6554 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40 MMHG OR GREATER, EACH |
| A6555 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40 MMHG OR GREATER, CUSTOM, EACH |
| A6556 | GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 18-30 MMHG, CUSTOM, EACH |
| A6557 | GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 30-40 MMHG, CUSTOM, EACH |
| A6558 | GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 40 MMHG OR GREATER, CUSTOM, EACH |
| A6559 | GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 18-30 MMHG, CUSTOM, EACH |
| A6560 | GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 30-40 MMHG, CUSTOM, EACH |
| A6561 | GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 40 MMHG OR GREATER, CUSTOM, EACH |
| A6562 | GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 18-30 MMHG, CUSTOM, EACH |
| A6563 | GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 30-40 MMHG, CUSTOM, EACH |
| A6564 | GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 40 MMHG OR GREATER, CUSTOM, EACH |
| A6565 | GRADIENT COMPRESSION GAUNTLET, CUSTOM, EACH |
| A6566 | GRADIENT COMPRESSION GARMENT, NECK/HEAD, EACH |
| A6567 | GRADIENT COMPRESSION GARMENT, NECK/HEAD, CUSTOM, EACH |
| A6568 | GRADIENT COMPRESSION GARMENT, TORSO AND SHOULDER, EACH |
| A6569 | GRADIENT COMPRESSION GARMENT, TORSO/SHOULDER, CUSTOM, EACH |
| A6570 | GRADIENT COMPRESSION GARMENT, GENITAL REGION, EACH |
| A6571 | GRADIENT COMPRESSION GARMENT, GENITAL REGION, CUSTOM, EACH |
| A6572 | GRADIENT COMPRESSION GARMENT, TOE CAPS, EACH |
| A6573 | GRADIENT COMPRESSION GARMENT, TOE CAPS, CUSTOM, EACH |
| A6574 | GRADIENT COMPRESSION ARM SLEEVE AND GLOVE COMBINATION, CUSTOM, EACH |
| A6575 | GRADIENT COMPRESSION ARM SLEEVE AND GLOVE COMBINATION, EACH |
| A6576 | GRADIENT COMPRESSION ARM SLEEVE, CUSTOM, MEDIUM WEIGHT, EACH |
| A6577 | GRADIENT COMPRESSION ARM SLEEVE, CUSTOM, HEAVY WEIGHT, EACH |
| A6578 | GRADIENT COMPRESSION ARM SLEEVE, EACH |
| A6579 | GRADIENT COMPRESSION GLOVE, CUSTOM, MEDIUM WEIGHT, EACH |
| A6580 | GRADIENT COMPRESSION GLOVE, CUSTOM, HEAVY WEIGHT, EACH |
| A6581 | GRADIENT COMPRESSION GLOVE, EACH |
| A6582 | GRADIENT COMPRESSION GAUNTLET, EACH |
| A6583 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, BELOW KNEE, 30-50 MMHG, EACH |
| A6584 | GRADIENT COMPRESSION WRAP WITH ADJUSTABLE STRAPS, NOT OTHERWISE SPECIFIED |
| A6585 | GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, ABOVE KNEE, EACH |
| A6586 | GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, FULL LEG, EACH |
| A6587 | GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, FOOT, EACH |
| A6588 | GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, ARM, EACH |
| A6589 | GRADIENT PRESSURE WRAP WITH ADJUSTABLE STRAPS, BRA, EACH |
| A6593 | ACCESSORY FOR GRADIENT COMPRESSION GARMENT OR WRAP WITH ADJUSTABLE STRAPS, NOT-OTHERWISE SPECIFIED |
| A6594 | GRADIENT COMPRESSION BANDAGING SUPPLY, BANDAGE LINER, LOWER EXTREMITY, ANY SIZE OR LENGTH, EACH |
| A6595 | GRADIENT COMPRESSION BANDAGING SUPPLY, BANDAGE LINER, UPPER EXTREMITY, ANY SIZE OR LENGTH, EACH |
| A6596 | GRADIENT COMPRESSION BANDAGING SUPPLY, CONFORMING GAUZE, PER LINEAR YARD, ANY WIDTH, EACH |
| A6597 | GRADIENT COMPRESSION BANDAGE ROLL, ELASTIC LONG STRETCH, LINEAR YARD, ANY WIDTH, EACH |
| A6598 | GRADIENT COMPRESSION BANDAGE ROLL, ELASTIC MEDIUM STRETCH, PER LINEAR YARD, ANY WIDTH, EACH |
| A6599 | GRADIENT COMPRESSION BANDAGE ROLL, INELASTIC SHORT STRETCH, PER LINEAR YARD, ANY WIDTH, EACH |
| A6600 | GRADIENT COMPRESSION BANDAGING SUPPLY, HIGH DENSITY FOAM SHEET, PER 250 SQUARE CENTIMETERS, EACH |
| A6601 | GRADIENT COMPRESSION BANDAGING SUPPLY, HIGH DENSITY FOAM PAD, ANY SIZE OR SHAPE, EACH |
| A6602 | GRADIENT COMPRESSION BANDAGING SUPPLY, HIGH DENSITY FOAM ROLL FOR BANDAGE, PER LINEAR YARD, ANY WIDTH, EACH |
| A6603 | GRADIENT COMPRESSION BANDAGING SUPPLY, LOW DENSITY CHANNEL FOAM SHEET, PER 250 SQUARE CENTIMETERS, EACH |
| A6604 | GRADIENT COMPRESSION BANDAGING SUPPLY, LOW DENSITY FLAT FOAM SHEET, PER 250 SQUARE CENTIMETERS, EACH |
| A6605 | GRADIENT COMPRESSION BANDAGING SUPPLY, PADDED FOAM, PER LINEAR YARD, ANY WIDTH, EACH |
| A6606 | GRADIENT COMPRESSION BANDAGING SUPPLY, PADDED TEXTILE, PER LINEAR YARD, ANY WIDTH, EACH |
| A6607 | GRADIENT COMPRESSION BANDAGING SUPPLY, TUBULAR PROTECTIVE ABSORPTION LAYER, PER LINEAR YARD, ANY WIDTH, EACH |
| A6608 | GRADIENT COMPRESSION BANDAGING SUPPLY, TUBULAR PROTECTIVE ABSORPTION PADDED LAYER, PER LINEAR YARD, ANY WIDTH, EACH |
| A6609 | GRADIENT COMPRESSION BANDAGING SUPPLY, NOT OTHERWISE SPECIFIED |
| A6610 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, CUSTOM, EACH |
Orthopedic Footwear
| Code | Narrative |
|---|---|
| L3161 | FOOT, ADDUCTUS POSITIONING DEVICE, ADJUSTABLE |
Suction Pumps
| Code | Narrative |
|---|---|
| E2001 | SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC, ANY TYPE, FOR USE WITH EXTERNAL URINE MANAGEMENT SYSTEM |
Miscellaneous
| Code | Narrative |
|---|---|
| A4287 | DISPOSABLE COLLECTION AND STORAGE BAG FOR BREAST MILK, ANY SIZE, ANY TYPE, EACH |
| A4457 | ENEMA TUBE, WITH OR WITHOUT ADAPTER, ANY TYPE, REPLACEMENT ONLY, EACH |
| A4468 | EXSUFFLATION BELT, INCLUDES ALL SUPPLIES AND ACCESSORIES |
| A4540 | DISTAL TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR, STIMULATES PERIPHERAL NERVES OF THE UPPER ARM |
| A4541 | MONTHLY SUPPLIES FOR USE OF DEVICE CODED AT E0733 |
| A4542 | SUPPLIES AND ACCESSORIES FOR EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST |
| A7023 | MECHANICAL ALLERGEN PARTICLE BARRIER/INHALATION FILTER, CREAM, NASAL, TOPICAL |
| E0492 | POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY PHONE APPLICATION |
| 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 |
| E0530 | ELECTRONIC POSITIONAL OBSTRUCTIVE SLEEP APNEA TREATMENT, WITH SENSOR, INCLUDES ALL COMPONENTS AND ACCESSORIES, ANY TYPE |
| E0678 | NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, FULL LEG |
| E0679 | NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, HALF LEG |
| E0680 | NON-PNEUMATIC COMPRESSION CONTROLLER WITH SEQUENTIAL CALIBRATED GRADIENT PRESSURE |
| E0681 | NON-PNEUMATIC COMPRESSION CONTROLLER WITHOUT CALIBRATED GRADIENT PRESSURE |
| E0682 | NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, FULL ARM |
| E0732 | CRANIAL ELECTROTHERAPY STIMULATION (CES) SYSTEM, ANY TYPE |
| E0733 | TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR FOR ELECTRICAL STIMULATION OF THE TRIGEMINAL NERVE |
| E0734 | EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST |
| E0735 | NON-INVASIVE VAGUS NERVE STIMULATOR |
| E1301 | WHIRLPOOL TUB, WALK-IN, PORTABLE |
| E3000 | SPEECH VOLUME MODULATION SYSTEM, ANY TYPE, INCLUDING ALL COMPONENTS AND ACCESSORIES |
Discontinued Codes
Lower Limb Prostheses
| Code | Narrative | Crosswalk to Code |
|---|---|---|
| K1014 | ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, 4 BAR LINKAGE OR MULTIAXIAL, FLUID SWING AND STANCE PHASE CONTROL | L5615 |
| K1022 | ADDITION TO LOWER EXTREMITY PROSTHESIS, ENDOSKELETAL, KNEE DISARTICULATION, ABOVE KNEE, HIP DISARTICULATION, POSITIONAL ROTATION UNIT, ANY TYPE | L5926 |
Orthopedic Footwear
| Code | Narrative | Crosswalk to Code |
|---|---|---|
| K1015 | FOOT, ADDUCTUS POSITIONING DEVICE, ADJUSTABLE | L3161 |
Suction Pumps
| Code | Narrative | Crosswalk to Code |
|---|---|---|
| K1006 | SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC, ANY TYPE, FOR USE WITH EXTERNAL URINE MANAGEMENT SYSTEM | E2001 |
Miscellaneous
| Code | Narrative | Crosswalk to Code |
|---|---|---|
| K1001 | ELECTRONIC POSITIONAL OBSTRUCTIVE SLEEP APNEA TREATMENT, WITH SENSOR, INCLUDES ALL COMPONENTS AND ACCESSORIES, ANY TYPE | E0530 |
| K1002 | CRANIAL ELECTROTHERAPY STIMULATION (CES) SYSTEM, ANY TYPE | E0732 |
| K1003 | WHIRLPOOL TUB, WALK-IN, PORTABLE | E1301 |
| K1005 | DISPOSABLE COLLECTION AND STORAGE BAG FOR BREAST MILK, ANY SIZE, ANY TYPE, EACH | A4287 |
| K1009 | SPEECH VOLUME MODULATION SYSTEM, ANY TYPE, INCLUDING ALL COMPONENTS AND ACCESSORIES | E3000 |
| K1013 | ENEMA TUBE, WITH OR WITHOUT ADAPTER, ANY TYPE, REPLACEMENT ONLY, EACH | A4457 |
| K1016 | TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR FOR ELECTRICAL STIMULATION OF THE TRIGEMINAL NERVE | E0733 |
| K1017 | MONTHLY SUPPLIES FOR USE OF DEVICE CODED AT E0733 | A4541 |
| K1018 | EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST | E0734 |
| K1019 | SUPPLIES AND ACCESSORIES FOR EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST | A4542 |
| K1020 | NON-INVASIVE VAGUS NERVE STIMULATOR | E0735 |
| K1021 | EXSUFFLATION BELT, INCLUDES ALL SUPPLIES AND ACCESSORIES | A4468 |
| K1023 | DISTAL TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR, STIMULATES PERIPHERAL NERVES OF THE UPPER ARM | A4540 |
| K1024 | NON-PNEUMATIC COMPRESSION CONTROLLER WITH SEQUENTIAL CALIBRATED GRADIENT PRESSURE | E0680 |
| K1025 | NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, FULL ARM | E0682 |
| K1026 | MECHANICAL ALLERGEN PARTICLE BARRIER/INHALATION FILTER, CREAM, NASAL, TOPICAL | A7023 |
| K1028 | POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY PHONE APPLICATION | E0492 |
| 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 | E0493 |
| K1031 | NON-PNEUMATIC COMPRESSION CONTROLLER WITHOUT CALIBRATED GRADIENT PRESSURE | E0681 |
| K1032 | NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, FULL LEG | E0678 |
| K1033 | NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, HALF LEG | E0679 |
Narrative Changes Codes
Intravenous Immune Globulin
| Code | Old Narrative | New Narrative |
|---|---|---|
| Q2052 | SERVICES, SUPPLIES AND ACCESSORIES USED IN THE HOME UNDER THE MEDICARE INTRAVENOUS IMMUNE GLOBULIN (IVIG) DEMONSTRATION | SERVICES, SUPPLIES AND ACCESSORIES USED IN THE HOME FOR THE ADMINISTRATION OF INTRAVENOUS IMMUNE GLOBULIN (IVIG) |
Lymphedema Compression Treatment Items
| Code | Old Narrative | New Narrative |
|---|---|---|
| A6535 | GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 40-50 MMHG, EACH | GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 40 MMHG OR GREATER, EACH |
| A6538 | GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 40-50 MMHG, EACH | GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 40 MMHG OR GREATER, EACH |
| A6541 | GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 40-50 MMHG, EACH | GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 40 MMHG OR GREATER, EACH |
| A6549 | GRADIENT COMPRESSION STOCKING/SLEEVE, NOT OTHERWISE SPECIFIED | GRADIENT COMPRESSION GARMENT, NOT OTHERWISE SPECIFIED |
Surgical Dressings
| Code | Old Narrative | New Narrative |
|---|---|---|
| A6531 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, EACH | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, USED AS A SURGICAL DRESSING, EACH |
| A6532 | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, EACH | GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, USED AS A SURGICAL DRESSING, EACH |
| A6545 | GRADIENT COMPRESSION WRAP, NON-ELASTIC, BELOW KNEE, 30-50 MM HG, EACH | GRADIENT COMPRESSION WRAP, NON-ELASTIC, BELOW KNEE, 30-50 MMHG, USED AS A SURGICAL DRESSING, EACH |
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
| Date of Change | Description |
|---|---|
| 01/04/24 | Originally published |
Last Updated Jan 04 , 2024
