Retired - 2020 HCPCS Code Annual Update - Correct Coding
DME MAC Joint Publication
HCPCS Code Update - 2020
The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for 2020. The tables contain only the 2020 HCPCS codes applicable to items within Medicare DME MAC jurisdiction. There may be 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 January 1, 2020.
Code Change Categories
- Added Codes/Modifiers: Identifies newly created codes and modifiers
- 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 on or before December 31, 2019.
- Narrative Changes/Revised Modifiers: Identifies changes in the narrative descriptor for an existing code or modifier.
If there is a direct crosswalk for a discontinued/deleted code or modifier, the crosswalk code will be listed in the table. Crosswalked codes are effective for claims with dates of service on or after January 1, 2020.
There is no grace period for submission of a discontinued code/modifier for claims with dates of service in 2020.
For questions about correct coding, contact the PDAC Contact Center at 877-735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday, or email the PDAC by completing the DME PDAC Contact Form located on the PDAC Website.
Code Change Tables
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.
Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686)
Added Code:
| Code | Narrative |
|---|---|
| L2006 | KNEE ANKLE FOOT DEVICE, ANY MATERIAL, SINGLE OR DOUBLE UPRIGHT, SWING AND/OR STANCE PHASE MICROPROCESSOR CONTROL WITH ADJUSTABILTY, INCLUDES ALL COMPONENTS (E.G., SENSORS, BATTERIES CHARGER) ANY TYPE ACTIVATION, WITH OR WITHOUT ANKLE JOINT(S), CUSTOM FABRICATED |
External Breast Prosthesis (L33317)
Added Code:
| Code | Narrative |
|---|---|
| L8033 | NIPPLE PROSTHESIS, CUSTOM FABRICATED, REUSABLE, ANY MATERIAL, ANY TYPE, EACH |
Revised Long Code Narrative:
| Code | Old Narrative | New Narrative |
|---|---|---|
| L8032 | NIPPLE PROSTHESIS, REUSABLE, ANY TYPE, EACH | NIPPLE PROSTHESIS, PREFABRICATED, REUSABLE, ANY TYPE, EACH |
External Infusion Pumps (L33794)
Added Codes:
| Code | Narrative |
|---|---|
| A4226 | SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION PUMP WITH DOSAGE RATE ADJUSTMENT USING THERAPEUTIC CONTINUOUS GLUCOSE SENSING, PER WEEK |
| E0787 | EXTERNAL AMBULATORY INFUSION PUMP, INSULIN, DOSAGE RATE ADJUSTMENT USING THERAPEUTIC CONTINUOUS GLUCOSE SENSING |
Parenteral Nutrition (L33798)
Added Code:
| Code | Narrative |
|---|---|
| B4187 | OMEGAVEN, 10 GRAMS LIPIDS |
Revised Long Code Narrative:
| Code | Old Narrative | New Narrative |
|---|---|---|
| B4185 | PARENTAL NUTRITION SOLUTION, PER 10 GRAMS LIPIDS | PARENTERAL NUTRITION SOLUTION, NOT OTHERWISE SPECIFIED, 10 GRAMS LIPIDS |
Wheelchair Options/Accessories (L33792)
Added Code:
| Code | Narrative |
|---|---|
| E2398 | WHEELCHAIR ACCESSORY, DYNAMIC POSITIONING HARDWARE FOR BACK |
Miscellaneous Codes
Added Codes:
| Code | Narrative |
|---|---|
| K1001 | ELECTRONIC POSITIONAL OBSTRUCTIVE SLEEP APNEA TREATMENT, WITH SENSOR, INCLUDES ALL COMPONENTS AND ACCESSORIES, ANY TYPE |
| K1002 | CRANIAL ELECTROTHERAPY STIMULATION (CES) SYSTEM, INCLUDES ALL SUPPLIES AND ACCESSORIES, ANY TYPE |
| K1003 | WHIRLPOOL TUB, WALK-IN, PORTABLE |
| K1004 | LOW FREQUENCY ULTRASONIC DIATHERMY TREATMENT DEVICE FOR HOME USE, INCLUDES ALL COMPONENTS AND ACCESSORIES |
| K1005 | DISPOSABLE COLLECTION AND STORAGE BAG FOR BREAST MILK, ANY SIZE, ANY TYPE, EACH |
| Date | Update |
|---|---|
| 12/20/2019 | Published on PDAC website |
| 02/25/2020 | Retired and Revised |