HCPCS Level II Code

The Centers for Medicare & Medicaid Services (CMS) released on May 13 the July 2020 quarterly update to the HCPCS Level II file. There are 61 added codes to describe healthcare equipment and supplies not identified by CPT® codes, as well as nine deleted codes and three revised codes.

The July update to the HCPCS Level II code set is effective July 1, 2020 (except where noted). Medicare coverage and payment determinations for HCPCS Level II codes without specific Medicare coverage or payment indicators are left to the discretion of the Medicare Administrative Contractors processing the claims.

Added Codes

HCPCS Level II

LONG DESCRIPTION

C1748

Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable)

C1849

Skin substitute, synthetic, resorbable, per square centimeter

C9059

Injection, meloxicam, 1 mg

C9061

Injection, teprotumumab-trbw, 10 mg

C9063

Injection, eptinezumab-jjmr, 1 mg

C9122

Mometasone furoate sinus implant, 10 micrograms (sinuva)

C9759

Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when performed

C9760

Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right and left heart catheterization, transeptal puncture, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study

C9762

Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging

C9763

Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging

C9764

Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed

C9765

Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed

C9766

Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed

C9767

Revascularization, endovascular, open or percutaneous, any vessel(s); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed

C9803

Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source

G2025

Payment for a telehealth distant site service furnished by a rural health clinic (RHC) or federally qualified health center (FQHC) only

G2170

Percutaneous arteriovenous fistula creation (AVF), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performed

G2171

Percutaneous arteriovenous fistula creation (AVF), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed

J0223

Injection, givosiran, 0.5 mg

J0591

Injection, deoxycholic acid, 1 mg

J0691

Injection, lefamulin, 1 mg

J0742

Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg

J0791

Injection, crizanlizumab-tmca, 0.5 mg

J0896

Injection, luspatercept-aamt, 0.25 mg

J1201

Injection, cetirizine hydrochloride, 0.5 mg

J1429

Injection, golodirsen, 10 mg

J1558

Injection, immune globulin (Xembify), 100 mg

J3399

Injection, Onasemnogene abeparvovec-xioi, per treatment, up to 5×1015 vector genomes

J7169

Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg

J7204

Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu

J7333

Hyaluronan or derivative, visco-3, for intra-articular injection, per dose

J9177

Injection, enfortumab vedotin-ejfv, 0.25 mg

J9198

Injection, gemcitabine hydrochloride, (infugem), 100 mg

J9246

Injection, melphalan (evomela), 1 mg

J9358

Injection, fam-trastuzumab deruxtecan-nxki, 1 mg

Q4227

Amniocore, per square centimeter

Q4228

Bionextpatch, per square centimeter

Q4229

Cogenex amniotic membrane, per square centimeter

Q4230

Cogenex flowable amnion, per 0.5 cc

Q4231

Corplex P, per cc

Q4232

Corplex, per square centimeter

Q4233

Surfactor or nudyn, per 0.5 cc

Q4234

Xcellerate, per square centimeter

Q4235

Amniorepair or altiply, per square centimeter

Q4236

Carepatch, per square centimeter

Q4237

Cryo-cord, per square centimeter

Q4238

Derm-maxx, per square centimeter

Q4239

Amnio-maxx or amnio-maxx lite, per square centimeter

Q4240

Corecyte, for topical use only, per 0.5 cc

Q4241

Polycyte, for topical use only, per 0.5 cc

Q4242

Amniocyte plus, per 0.5 cc

Q4244

Procenta, per 200 mg

Q4245

Amniotext, per cc

Q4246

Coretext or protext, per cc

Q4247

Amniotext patch, per square centimeter

Q4248

Dermacyte amniotic membrane allograft, per square centimeter

Q5119*

Injection, Rituximab-pvvr, biosimilar, (Ruxience), 10 mg

Q5120*

Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg

Q5121

Injection, infliximab-axxq, biosimilar, (avsola), 10 mg

U0003

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R

U0004

2019-nCoV coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R
Discontinued Codes

HCPCS Level II

LONG DESCRIPTION

C9041

Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg

C9053

Injection, crizanlizumab-tmca, 1 mg

C9054

Injection, lefamulin (xenleta), 1 mg

C9056

Injection, givosiran, 0.5 mg

C9057

Injection, cetirizine hydrochloride, 1 mg

C9058

Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg

C9754

Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed)

C9755

Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed

J9199

Injection, gemcitabine hydrochloride (infugem), 200 mg
Long Description Change
HCPCS Level II LONG DESCRIPTION

J7321

Hyaluronan or derivative, hyalgan or supartz or visco-3, for intra-articular injection, per dose

J9245

Injection, melphalan hydrochloride, not otherwise specified, 50 mg

Q4176

Neopatch or therion, per square centimeter

*CMS will issue separate instructions regarding dates of service for Medicare.

For More Information: https://www.aapc.com/blog/50851-hcpcs-level-ii-code-changes-in-effect-july-1/

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