2024 HCPCS Code Update - October Edition - Correct Coding

Joint DME MAC and PDAC Publication
Posted September 26, 2024

The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for October 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 October 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 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, 2024. 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

External Infusion Pumps

Code Narrative
J1171 INJECTION, HYDROMORPHONE, 0.1 MG

Knee Orthoses

Code Narrative
L1821 KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, OFF THE SHELF

Speech Generating Devices (SGD)

Code Narrative
E2513 ACCESSORY FOR SPEECH GENERATING DEVICE, ELECTROMYOGRAPHIC SENSOR

Miscellaneous

Code Narrative
A4543 SUPPLIES FOR TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR, FOR NERVES IN THE AURICULAR REGION, PER MONTH
A4544 ELECTRODE FOR EXTERNAL LOWER EXTREMITY NERVE STIMULATOR FOR RESTLESS LEGS SYNDROME
A4545 SUPPLIES AND ACCESSORIES FOR EXTERNAL TIBIAL NERVE STIMULATOR (E.G., SOCKS, GEL PADS, ELECTRODES, ETC.), NEEDED FOR ONE MONTH
A7021 SUPPLIES AND ACCESSORIES FOR LUNG EXPANSION AIRWAY CLEARANCE, CONTINUOUS HIGH FREQUENCY OSCILLATION, AND NEBULIZATION DEVICE (E.G., HANDSET, NEBULIZER KIT, BIOFILTER)
E0469 LUNG EXPANSION AIRWAY CLEARANCE, CONTINUOUS HIGH FREQUENCY OSCILLATION, AND NEBULIZATION DEVICE
E0683 NON-PNEUMATIC, NON-SEQUENTIAL, PERISTALTIC WAVE COMPRESSION PUMP
E0715 INTRAVAGINAL DEVICE INTENDED TO STRENGTHEN PELVIC FLOOR MUSCLES DURING KEGEL EXERCISES
E0716 SUPPLIES AND ACCESSORIES FOR INTRAVAGINAL DEVICE INTENDED TO STRENGTHEN PELVIC FLOOR MUSCLES DURING KEGEL EXERCISES
E0721 TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR FOR NERVES IN THE AURICULAR REGION
E0737 TRANSCUTANEOUS TIBIAL NERVE STIMULATOR, CONTROLLED BY PHONE APPLICATION
E0743 EXTERNAL LOWER EXTREMITY NERVE STIMULATOR FOR RESTLESS LEGS SYNDROME, EACH
E0767 INTRABUCCAL, SYSTEMIC DELIVERY OF AMPLITUDE-MODULATED, RADIOFREQUENCY ELECTROMAGNETIC FIELD DEVICE, FOR CANCER TREATMENT, INCLUDES ALL ACCESSORIES
E3200 GAIT MODULATION SYSTEM, RHYTHMIC AUDITORY STIMULATION, INCLUDING RESTRICTED THERAPY SOFTWARE, ALL COMPONENTS AND ACCESSORIES, PRESCRIPTION ONLY
J0138 INJECTION, ACETAMINOPHEN 10 MG AND IBUPROFEN 3 MG
J1749 INJECTION, ILOPROST, 0.1 MCG
J2002 INJECTION, LIDOCAINE HCL IN 5% DEXTROSE, 1 MG
J2003 INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG
J2004 INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG
J2252 INJECTION, MIDAZOLAM IN 0.8% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG
J2253 INJECTION, MIDAZOLAM (SEIZALAM), 1 MG
J2601 INJECTION, VASOPRESSIN (BAXTER), 1 UNIT
J8522 CAPECITABINE, ORAL, 50 MG
J8541 DEXAMETHASONE (HEMADY), ORAL, 0.25 MG
J9329 INJECTION, TISLELIZUMAB-JSGR, 1MG
L1006 SCOLIOSIS ORTHOSIS, SAGITTAL-CORONAL CONTROL PROVIDED BY A RIGID LATERAL FRAME, EXTENDS FROM AXILLA TO TROCHANTER, INCLUDES ALL ACCESSORY PADS, STRAPS AND INTERFACE, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE
L1653 HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRICATED, OFF THE SHELF
L8720 EXTERNAL LOWER EXTREMITY SENSORY PROSTHESIS, CUTANEOUS STIMULATION OF MECHANORECEPTORS PROXIMAL TO THE ANKLE, PER LEG
L8721 RECEPTOR SOLE FOR USE WITH L8720, REPLACEMENT, EACH
Q0519 PHARMACY SUPPLYING FEE FOR HIV PRE-EXPOSURE PROPHYLAXIS FDA APPROVED PRESCRIPTION INJECTABLE DRUG, PER 30-DAYS
Q0520 PHARMACY SUPPLYING FEE FOR HIV PRE-EXPOSURE PROPHYLAXIS FDA APPROVED PRESCRIPTION INJECTABLE DRUG, PER 60-DAYS
Q5135 INJECTION, TOCILIZUMAB-AAZG (TYENNE), BIOSIMILAR, 1 MG
Q5136 INJECTION, DENOSUMAB-BBDZ (JUBBONTI/WYOST), BIOSIMILAR, 1 MG

Discontinued Codes

External Infusion Pumps

Code Narrative
J1170 INJECTION, HYDROMORPHONE, UP TO 4 MG

Miscellaneous

Code Narrative
J2001 INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG
J8520 CAPECITABINE, ORAL, 150 MG
J8521 CAPECITABINE, ORAL, 500 MG
J9258 INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES (TEVA), NOT THERAPEUTICALLY EQUIVALENT TO J9264, 1 MG

Narrative Changes

Glucose Monitors

Code Old Narrative New Narrative
A4271 INTEGRATED LANCING AND BLOOD SAMPLE TESTING CARTRIDGES FOR HOME BLOOD GLUCOSE MONITOR, PER MONTH INTEGRATED LANCING AND BLOOD SAMPLE TESTING CARTRIDGES FOR HOME BLOOD GLUCOSE MONITOR, PER 50 TESTS

Knee Orthoses

Code Old Narrative New Narrative
L1820 KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE

Miscellaneous

Code Old Narrative New Narrative
E0739 REHAB SYSTEM WITH INTERACTIVE INTERFACE PROVIDING ACTIVE ASSISTANCE IN REHABILITATION THERAPY, INCLUDES ALL COMPONENTS AND ACCESSORIES, MOTORS, MICROPROCESSORS, SENSORS REHABILITATION SYSTEM WITH INTERACTIVE INTERFACE PROVIDING ACTIVE ASSISTANCE IN REHABILITATION THERAPY, INCLUDES ALL COMPONENTS AND ACCESSORIES, MOTORS, MICROPROCESSORS, SENSORS
J2251 INJECTION, MIDAZOLAM HYDROCHLORIDE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J2250, PER 1 MG INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG
J9172 INJECTION, DOCETAXEL (INGENUS), NOT THERAPEUTICALLY EQUIVALENT TO J9171, 1 MG INJECTION, DOCETAXEL (DOCIVYX), 1 MG
L1652 HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT, ANY TYPE HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE

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.

Revision History

Date of Change Description
09/26/24 Originally Published
Last Updated Sep 26 , 2024