Joint DME MAC and PDAC Publication
The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2023. 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, 2023.
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 March 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 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
Suction Pumps
| Code |
Narrative |
| A6590 |
EXTERNAL URINARY CATHETERS, DISPOSABLE, WITH WICKING MATERIAL, FOR USE WITH SUCTION PUMP, PER MONTH |
| A6591 |
EXTERNAL URINARY CATHETER; NON-DISPOSABLE, FOR USE WITH SUCTION PUMP, PER MONTH |
Urological Supplies
| Code |
Narrative |
| A4341 |
INDWELLING INTRAURETHRAL DRAINAGE DEVICE WITH VALVE, PATIENT INSERTED, REPLACEMENT ONLY, EACH |
| A4342 |
ACCESSORIES FOR PATIENT INSERTED INDWELLING INTRAURETHRAL DRAINAGE DEVICE WITH VALVE, REPLACEMENT ONLY, EACH |
Miscellaneous
| Code |
Narrative |
| A4560 |
NEUROMUSCULAR ELECTRICAL STIMULATOR (NMES), DISPOSABLE, REPLACEMENT ONLY |
| A7049 |
EXPIRATORY POSITIVE AIRWAY PRESSURE INTRANASAL RESISTANCE VALVE |
| E0677 |
NON-PNEUMATIC SEQUENTIAL COMPRESSION GARMENT, TRUNK |
| E0711 |
UPPER EXTREMITY MEDICAL TUBING/LINES ENCLOSURE OR COVERING DEVICE, RESTRICTS ELBOW RANGE OF MOTION |
| E1905 |
VIRTUAL REALITY COGNITIVE BEHAVIORAL THERAPY DEVICE (CBT), INCLUDING PRE-PROGRAMMED THERAPY SOFTWARE |
| K1035 |
MOLECULAR DIAGNOSTIC TEST READER, NONPRESCRIPTION SELF-ADMINISTERED AND SELF-COLLECTED USE, FDA APPROVED, AUTHORIZED OR CLEARED |
Modifiers
| Code |
Narrative |
| JK |
ONE MONTH SUPPLY OR LESS OF DRUG OR BIOLOGICAL |
| JL |
THREE MONTH SUPPLY OF DRUG OR BIOLOGICAL |
Narrative Changes
Suction Pumps
| Code |
Old Narrative |
New Narrative |
| A4628 |
OROPHARYNGEAL SUCTION CATHETER, EACH |
ORAL AND/OR OROPHARYNGEAL SUCTION CATHETER, EACH |
Miscellaneous
| Code |
Old Narrative |
New Narrative |
| K1019 |
REPLACEMENT SUPPLIES AND ACCESSORIES FOR EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST |
SUPPLIES AND ACCESSORIES FOR EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST |
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 |
Update |
| 05/05/2023 |
Published on PDAC website |