Modifier and HCPCS Changes for January 2024 - JE Part B
Modifier and HCPCS Changes for January 2024
The following new and deleted National Level II modifiers and Healthcare Common Procedure Coding System (HCPCS) are effective for dates of service on/after January 1, 2024.
In compliance with the Health Insurance Portability and Accountability Act (HIPAA), CMS eliminated the 3-month grace period for discontinued codes in Change Request (CR) 3093 dated February 6, 2004. Effective for dates of services on/after January 1, 2010, there is no grace period for billing discontinued HCPCS codes.
Note: The inclusion of modifiers or codes on this web page do not necessarily indicate coverage. New modifiers and HCPCS identified as Durable Medical Equipment (DME) are not included in this listing.
New Modifiers
There are no new modifiers being implemented.New Codes
| HCPCS | DESCRIPTION |
|---|---|
| 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 |
| 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, non-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 |
| A7023 | Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical |
| A9608 | Flotufolastat f 18, diagnostic, 1 millicurie |
| A9609 | Fludeoxyglucose f18 up to 15 millicuries |
| C1600 | Catheter, transluminal intravascular lesion preparation device, bladed, sheathed (insertable) |
| C1601 | Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable) |
| C1602 | Orthopedic/device/drug matrix/absorbable bone void filler, antimicrobial-eluting (implantable) |
| C1603 | Retrieval device, insertable, laser (used to retrieve intravascular inferior vena cava filter) |
| C1604 | Graft, transmural transvenous arterial bypass (implantable), with all delivery system components |
| C7556 | Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s), including fluoroscopic guidance, when performed |
| C7557 | Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed and intraprocedural coronary fractional flow reserve (ffr) with 3d functional mapping of color-coded ffr values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention |
| C7558 | Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography with pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed |
| C7560 | Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) |
| C7561 | Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less with manual preparation and insertion of drug-delivery device(s), deep (e.g., subfascial) |
| C7903 | Group psychotherapy service for diagnosis, evaluation, or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
| C9159 | Injection, prothrombin complex concentrate (human), balfaxar, per i.u. of factor ix activity |
| C9160 | Injection, daxibotulinumtoxina-lanm, 1 unit |
| C9161 | Injection, aflibercept hd, 1 mg |
| C9162 | Injection, avacincaptad pegol, 0.1 mg |
| C9163 | Injection, talquetamab-tgvs, 0.25 mg |
| C9164 | Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg) |
| C9165 | Injection, elranatamab-bcmm, 1 mg |
| C9793 | 3d predictive model generation for pre-planning of a cardiac procedure, using data from cardiac computed tomographic angiography with report |
| C9794 | Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling) |
| C9795 | Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions |
| D0396 | 3d printing of a 3d dental surface scan |
| D1301 | Immunization counseling |
| D2976 | Band stabilization - per tooth |
| D2989 | Excavation of a tooth resulting in the determination of non-restorability |
| D2991 | Application of hydroxyapatite regeneration medicament - per tooth |
| D6089 | Accessing and retorquing loose implant screw - per screw |
| D7284 | Excisional biopsy of minor salivary glands |
| D7939 | Indexing for osteotomy using dynamic robotic assisted or dynamic navigation |
| D9938 | Fabrication of a custom removable clear plastic temporary aesthetic appliance |
| D9939 | Placement of a custom removable clear plastic temporary aesthetic appliance |
| D9954 | Fabrication and delivery of oral appliance therapy (oat) morning repositioning device |
| D9955 | Oral appliance therapy (oat) titration visit |
| D9956 | Administration of home sleep apnea test |
| D9957 | Screening for sleep related breathing disorders |
| 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 |
| E2001 | Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system |
| E3000 | Speech volume modulation system, any type, including all components and accessories |
| G0011 | Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes |
| G0012 | Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle |
| G0013 | Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence |
| G0017 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes |
| G0018 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service) |
| G0019 | Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(s) that are significantly limiting the ability to diagnose or treat problem(s) addressed in an initiating visit: person-centered assessment, performed to better understand the individualized context of the intersection between the sdoh need(s) and the problem(s) addressed in the initiating visit. ++ conducting a person-centered assessment to understand patient's life story, strengths, needs, goals, preferences and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal-setting and establishing an action plan. ++ providing tailored support to the patient as needed to accomplish the practitioner's treatment plan. practitioner, home-, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; and from home- and community-based service providers, social service providers, and caregiver (if applicable). ++ communication with practitioners, home- and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) to address the sdoh need(s). health education- helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, and preferences, in the context of the sdoh need(s), and educating the patient on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services addressing the sdoh need(s), in ways that are more likely to promote personalized and effective diagnosis or treatment. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care and helping secure appointments with them. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the problem(s) addressed in the initiating visit, the sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leveraging lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals |
| G0022 | Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019) |
| G0023 | Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities: person-centered assessment, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered assessment to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; home- and community-based service providers; and caregiver (if applicable). ++ communication with practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, likely to promote personalized and effective treatment of their condition. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care, and helping secure appointments with them. ++ providing the patient with information/resources to consider participation in clinical trials or clinical research as applicable. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals |
| G0024 | Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023) |
| G0136 | Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes |
| G0137 | Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
| G0140 | Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered interview to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors, and including unmet sdoh needs (that are not billed separately). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the person-centered goals in the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care communication. ++ assist the patient in communicating with their practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education. helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. developing and proposing strategies to help meet person-centered treatment goals and supporting the patient in using chosen strategies to reach person-centered treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet person-centered diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals |
| G0146 | Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140) |
| G9886 | Behavioral counseling for diabetes prevention, in-person, group, 60 minutes |
| G9887 | Behavioral counseling for diabetes prevention, distance learning, 60 minutes |
| G9888 | Maintenance 5% wl from baseline weight in months 7-12 |
| J0184 | Injection, amisulpride, 1 mg |
| J0217 | Injection, velmanase alfa-tycv, 1 mg |
| J0391 | Injection, artesunate, 1 mg |
| J0402 | Injection, aripiprazole (abilify asimtufii), 1 mg |
| J0576 | Injection, buprenorphine extended-release (brixadi), 1 mg |
| J0688 | Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
| J0750 | Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) |
| J0751 | Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) |
| J0799 | Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified |
| J0873 | Injection, daptomycin (xellia) not therapeutically equivalent to j0878, 1 mg |
| J1105 | Dexmedetomidine, oral, 1 mcg |
| J1304 | Injection, tofersen, 1 mg |
| J1412 | Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes |
| J1413 | Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose |
| J1596 | Injection, glycopyrrolate, 0.1 mg |
| J1939 | Injection, bumetanide, 0.5 mg |
| J2404 | Injection, nicardipine, 0.1 mg |
| J2508 | Injection, pegunigalsidase alfa-iwxj, 1 mg |
| J2679 | Injection, fluphenazine hcl, 1.25 mg |
| J2799 | Injection, risperidone (uzedy), 1 mg |
| J3401 | Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml |
| J3425 | Injection, hydroxocobalamin, 10 mcg |
| J9052 | Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg |
| J9072 | Injection, cyclophosphamide, (dr. reddy's), 5 mg |
| J9172 | Injection, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg |
| J9255 | Injection, methotrexate (accord) not therapeutically equivalent to j9250 and j9260, 50 mg |
| J9258 | Injection, paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264, 1 mg |
| J9286 | Injection, glofitamab-gxbm, 2.5 mg |
| J9321 | Injection, epcoritamab-bysp, 0.16 mg |
| J9324 | Injection, pemetrexed (pemrydi rtu), 10 mg |
| J9333 | Injection, rozanolixizumab-noli, 1 mg |
| J9334 | Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc |
| L3161 | Foot, adductus positioning device, adjustable |
| 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 |
| M1211 | Most recent hemoglobin a1c level > 9.0% |
| M1212 | Hemoglobin a1c level is missing, or was not performed during the measurement period (12 months) |
| M1213 | No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70% |
| M1214 | Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed |
| M1215 | Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy) |
| M1216 | No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter |
| M1217 | Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter) |
| M1218 | Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing) |
| M1219 | Anaphylaxis due to the vaccine on or before the date of the encounter |
| M1220 | Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy |
| M1221 | Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy |
| M1222 | Glaucoma plan of care not documented, reason not otherwise specified |
| M1223 | Glaucoma plan of care documented |
| M1224 | Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level |
| M1225 | Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level |
| M1226 | Iop measurement not documented, reason not otherwise specified |
| M1227 | Evidence-based therapy was prescribed |
| M1228 | Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test |
| M1229 | Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection |
| M1230 | Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given |
| M1231 | Patient receives hcv antibody test with nonreactive result |
| M1232 | Patient receives hcv antibody test with reactive result |
| M1233 | Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given |
| M1234 | Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia |
| M1235 | Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period |
| M1236 | Baseline mrs > 2 |
| M1237 | Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons) |
| M1238 | Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31) |
| M1239 | Patient did not respond to the question of patient felt heard and understood by this provider and team |
| M1240 | Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care |
| M1241 | Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem |
| M1242 | Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life |
| M1243 | Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team |
| M1244 | Patient provided a response other than "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care |
| M1245 | Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem |
| M1246 | Patient provided a response other than "completely true" for the question of patient felt this provider and team understood what is important to me in my life |
| M1247 | Patient responded "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care |
| M1248 | Patient responded "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem |
| M1249 | Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life |
| M1250 | Patient responded as "completely true" for the question of patient felt heard and understood by this provider and team |
| M1251 | Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement) |
| M1252 | Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit |
| M1253 | Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal) |
| M1254 | Patients who were deceased when the hu survey reached them |
| M1255 | Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere) |
| M1256 | Prior history of known cvd |
| M1257 | Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified |
| M1258 | Cvd risk assessment performed, have a documented calculated risk score |
| M1259 | Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis |
| M1260 | Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of dialysis |
| M1261 | Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis |
| M1262 | Patients who had a transplant prior to initiation of dialysis |
| M1263 | Patients in hospice on their initiation of dialysis date or during the month of evaluation |
| M1264 | Patients age 75 or older on their initiation of dialysis date |
| M1265 | Cms medical evidence form 2728 for dialysis patients: initial form completed |
| M1266 | Patients admitted to a skilled nursing facility (snf) |
| M1267 | Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period |
| M1268 | Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period |
| M1269 | Receiving esrd mcp dialysis services by the provider on the last day of the reporting month |
| M1270 | Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period |
| M1271 | Patients with dementia at any time prior to or during the month |
| M1272 | Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period |
| M1273 | Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form |
| M1274 | Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month |
| M1275 | Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period |
| M1276 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
| M1277 | Colorectal cancer screening results documented and reviewed |
| M1278 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
| M1279 | Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
| M1280 | Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy |
| M1281 | Blood pressure reading not documented, reason not given |
| M1282 | Patient screened for tobacco use and identified as a tobacco non-user |
| M1283 | Patient screened for tobacco use and identified as a tobacco user |
| M1284 | Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period |
| M1285 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified |
| M1286 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
| M1287 | Bmi is documented below normal parameters and a follow-up plan is documented |
| M1288 | Documented reason for not screening or recommending a follow-up for high blood pressure |
| M1289 | Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
| M1290 | Patient not eligible due to active diagnosis of hypertension |
| M1291 | Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period |
| M1292 | Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| M1293 | Bmi is documented above normal parameters and a follow-up plan is documented |
| M1294 | Normal blood pressure reading documented, follow-up not required |
| M1295 | Patients with a diagnosis or past history of total colectomy or colorectal cancer |
| M1296 | Bmi is documented within normal parameters and no follow-up plan is required |
| M1297 | Bmi not documented due to medical reason or patient refusal of height or weight measurement |
| M1298 | Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter |
| M1299 | Influenza immunization administered or previously received |
| M1300 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
| M1301 | Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
| M1302 | Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed |
| M1303 | Hospice services provided to patient any time during the measurement period |
| M1304 | Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period |
| M1305 | Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period |
| M1306 | Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period |
| M1307 | Documentation stating the patient has received or is currently receiving palliative or hospice care |
| M1308 | Influenza immunization was not administered, reason not given |
| M1309 | Palliative care services provided to patient any time during the measurement period |
| M1310 | Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user |
| M1311 | Anaphylaxis due to the vaccine on or before the date of the encounter |
| M1312 | Patient not screened for tobacco use |
| M1313 | Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period |
| M1314 | Bmi not documented and no reason is given |
| M1315 | Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified |
| M1316 | Current tobacco non-user |
| M1317 | Patients who are counseled on connection with a csp and explicitly opt out |
| M1318 | Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp |
| M1319 | Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening |
| M1320 | Patients who screened positive for at least 1 of the 5 hrsns |
| M1321 | Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg |
| M1322 | Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye |
| M1323 | Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented |
| M1324 | Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant) |
| M1325 | Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment) |
| M1326 | Patients with a diagnosis of hypotony |
| M1327 | Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks |
| M1328 | Patients with a diagnosis of acute vitreous hemorrhage |
| M1329 | Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter |
| M1330 | Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up) |
| M1331 | Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam |
| M1332 | Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks |
| M1333 | Acute vitreous hemorrhage |
| M1334 | Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter |
| M1335 | Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up) |
| M1336 | Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks |
| M1337 | Acute pvd |
| M1338 | Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period |
| M1339 | Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period |
| M1340 | Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period |
| M1341 | Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period |
| M1342 | Patients who died during the performance period |
| M1343 | Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam |
| M1344 | Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score |
| M1345 | Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score |
| M1346 | Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period |
| M1347 | Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing) |
| M1348 | Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent) |
| M1349 | Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period |
| M1350 | Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter |
| M1351 | Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation |
| M1352 | Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment |
| M1353 | Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter |
| M1354 | Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation |
| M1355 | Suicide risk based on their clinician's evaluation or a clinician-rated tool |
| M1356 | Patients who died during the measurement period |
| M1357 | Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment |
| M1358 | Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment |
| M1359 | Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained |
| M1360 | Suicidal ideation and/or behavior symptoms based on the c-ssrs |
| M1361 | Suicide risk based on their clinician's evaluation or a clinician-rated tool |
| M1362 | Patients who died during the measurement period |
| M1363 | Patients who did not have a follow-up assessment within 120 days of the index assessment |
| M1364 | Calculated 10-year ascvd risk score of >= 20 percent during the performance period |
| M1365 | Patient encounter during the performance period with hospice and palliative care specialty code 17 |
| M1366 | Focusing on women's health mips value pathway |
| M1367 | Quality care for the treatment of ear, nose, and throat disorders mips value pathway |
| M1368 | Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway |
| M1369 | Quality care in mental health and substance use disorders mips value pathway |
| M1370 | Rehabilitative support for musculoskeletal care mips value pathway |
| Q0516 | Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 30-days |
| Q0517 | Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 60-days |
| Q0518 | Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug, per 90-days |
| Q4279 | Vendaje ac, per square centimeter |
| Q4287 | Dermabind dl, per square centimeter |
| Q4288 | Dermabind ch, per square centimeter |
| Q4289 | Revoshield + amniotic barrier, per square centimeter |
| Q4290 | Membrane wrap-hydro, per square centimeter |
| Q4291 | Lamellas xt, per square centimeter |
| Q4292 | Lamellas, per square centimeter |
| Q4293 | Acesso dl, per square centimeter |
| Q4294 | Amnio quad-core, per square centimeter |
| Q4295 | Amnio tri-core amniotic, per square centimeter |
| Q4296 | Rebound matrix, per square centimeter |
| Q4297 | Emerge matrix, per square centimeter |
| Q4298 | Amnicore pro, per square centimeter |
| Q4299 | Amnicore pro+, per square centimeter |
| Q4300 | Acesso tl, per square centimeter |
| Q4301 | Activate matrix, per square centimeter |
| Q4302 | Complete aca, per square centimeter |
| Q4303 | Complete aa, per square centimeter |
| Q4304 | Grafix plus, per square centimeter |
| Q5132 | Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg |
Deleted Codes
| HCPCS | DESCRIPTION |
|---|---|
| C9152 | Injection, aripiprazole, (abilify asimtufii), 1 mg |
| C9153 | Injection, amisulpride, 1 mg |
| C9154 | Injection, buprenorphine extended-release (brixadi), 1 mg |
| C9155 | Injection, epcoritamab-bysp, 0.16 mg |
| C9156 | Flotufolastat f 18, diagnostic, 1 millicurie |
| C9157 | Injection, tofersen, 1 mg |
| C9158 | Injection, risperidone, (uzedy), 1 mg |
| C9770 | Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent |
| C9771 | Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral |
| C9788 | Opto-acoustic imaging, breast (including axilla when performed), unilateral, with image documentation, analysis and report, obtained with ultrasound examination |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
| G0056 | Optimizing chronic disease management mips value pathways |
| G2066 | Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
| G2108 | Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period |
| G2109 | Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period |
| G2110 | Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period |
| G8506 | Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
| G8818 | Patient discharge to home no later than post-operative day #7 |
| G8825 | Patient not discharged to home by post-operative day #7 |
| G8852 | Positive airway pressure therapy was prescribed |
| G8883 | Biopsy results reviewed, communicated, tracked and documented |
| G8884 | Clinician documented reason that patient's biopsy results were not reviewed |
| G8885 | Biopsy results not reviewed, communicated, tracked or documented |
| G8941 | Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter |
| G8963 | Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years |
| G8964 | Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc) |
| G9192 | Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system) |
| G9229 | Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception) |
| G9451 | Patient received one-time screening for hcv infection |
| G9453 | Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons) |
| G9454 | One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given |
| G9596 | Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma |
| G9612 | Photodocumentation of two or more cecal landmarks to establish a complete examination |
| G9613 | Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.) |
| G9614 | Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination |
| G9697 | Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator |
| G9715 | Patients who use hospice services any time during the measurement period |
| G9725 | Patients who use hospice services any time during the measurement period |
| G9852 | Patients who died from cancer |
| G9853 | Patient admitted to the icu in the last 30 days of life |
| G9854 | Patient was not admitted to the icu in the last 30 days of life |
| G9927 | Documentation of system reason(s) for not prescribing an fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment |
| G9995 | Patients who use palliative care services any time during the measurement period |
| J9160 | Injection, denileukin diftitox, 300 micrograms |
| K1001 | Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type |
| K1002 | Cranial electrotherapy stimulation (ces) system, any type |
| K1003 | Whirlpool tub, walk-in, portable |
| K1005 | Disposable collection and storage bag for breast milk, any size, any type, each |
| K1006 | Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system |
| K1009 | Speech volume modulation system, any type, including all components and accessories |
| K1013 | Enema tube, with or without adapter, 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 | Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist |
| K1020 | Non-invasive vagus nerve stimulator |
| K1021 | Exsufflation belt, includes all supplies and accessories |
| K1022 | Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type |
| K1023 | Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm |
| K1024 | Non-pneumatic compression controller with sequential calibrated gradient pressure |
| K1026 | Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical |
| K1028 | Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, 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 |
| 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 |
| M1156 | Patient received active chemotherapy any time during the measurement period |
| M1157 | Patient received bone marrow transplant any time during the measurement period |
| M1158 | Patient had history of immunocompromising conditions prior to or during the measurement period |
| S0166 | Injection, olanzapine, 2.5 mg |
| S0171 | Injection, bumetanide, 0.5 mg |
Source
- Transmittal 12198, CR 13296 dated August 10, 2023
Last Updated Sep 16 , 2024
