2021 HCPCS Code Update - April Edition - Correct Coding

Joint DME MAC and PDAC Publication

Posted July 29, 2021

The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2021. 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, 2021.

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, 2021. 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

Intravenous Immune Globulin (L33610)

Code Narrative
J1554 INJECTION, IMMUNE GLOBULIN (ASCENIV), 500 MG

 

Miscellaneous

Code Narrative
K1013 ENEMA TUBE, ANY TYPE, REPLACEMENT ONLY, EACH
K1014 ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, 4 BAR LINKAGE OR MULTIAXIAL, FLUID SWING AND STANCE PHASE CONTROL
K1015 FOOT, ADDUCTUS POSITIONING DEVICE, ADJUSTABLE
K1016 TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR FOR ELECTRICAL STIMULATION OF THE TRIGEMINAL NERVE
K1017 MONTHLY SUPPLIES FOR USE OF DEVICE CODED AT K1016
K1018 EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST
K1019 MONTHLY SUPPLIES FOR USE OF DEVICE CODED AT K1018
K1020 NON-INVASIVE VAGUS NERVE STIMULATOR

 

Discontinued Codes

Urological Supplies

Code Narrative
K1010* INDWELLING INTRAURETHRAL DRAINAGE DEVICE WITH VALVE, PATIENT INSERTED, REPLACEMENT ONLY, EACH
K1011* ACTIVATION DEVICE FOR INTRAURETHRAL DRAINAGE DEVICE WITH VALVE, REPLACEMENT ONLY, EACH
K1012* CHARGER AND BASE STATION FOR INTRAURETHRAL ACTIVATION DEVICE, REPLACEMENT ONLY

 

* For claims with DOS April 1, 2021 and after, the inFlow Intraurethral Valve-Pump system (Vesiflo, Inc.) must be billed using HCPCS code A4335 (INCONTINENCE SUPPLY; MISCELLANEOUS). For more detailed information refer to Policy Article A52521.

For questions about correct coding or products not listed on the DMECS Product Classification List (PCL), contact the Pricing, Data Analysis and Coding (PDAC) HCPCS Helpline at (877) 735-1326 during the hours of 9:30 am to 5 pm 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
07/29/2021 Originally Published

 

Last Updated Dec 09 , 2023