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December 31, 2009
2010 - HCPCS Code Update
The following list identifies changes to level II Healthcare Common Procedure
Coding System (HCPCS) codes for 2010.
Added Codes/Added Modifiers: New codes and modifiers are
effective for dates of service on or after January 1, 2010.
Discontinued Codes/Deleted Modifiers: Codes or modifiers
that are discontinued/deleted will continue to be valid for claims with dates
of service on or before December 31, 2009, regardless of the date of claim
submission. If there is a direct crosswalk for a discontinued/deleted code
or modifier, it is listed in the table. The crosswalked codes are also "added" codes
effective for dates of service on or after January 1, 2010.
There is no grace period that would allow submission of the discontinued code
for dates of service in 2010.
Narrative Changes/Revised Modifiers: A description change
for an existing code or modifier is effective for dates of service on or after
January 1, 2010.
The appearance of a code in this list does not necessarily indicate coverage.
Ankle-Foot and Knee-Ankle-Foot Orthoses
Added Code
| Code |
Narrative |
| A4466 |
GARMENT, BELT, SLEEVE OR OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE
MATERIAL, ANY TYPE, EACH (Note: Noncovered) |
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| L4396 |
STATIC ANKLE FOOT ORTHOSIS, INCLUDING SOFT INTERFACE MATERIAL, ADJUSTABLE
FOR FIT, FOR POSITIONING, PRESSURE REDUCTION, MAY BE USED FOR MINIMAL AMBULATION,
PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT |
STATIC OR DYNAMIC ANKLE FOOT ORTHOSIS, INCLUDING SOFT INTERFACE MATERIAL,
ADJUSTABLE FOR FIT, FOR POSITIONING, MAY BE USED FOR MINIMAL AMBULATION,
PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT |
External Breast Prostheses
Added Code
| Code |
Narrative |
| L8031 |
BREAST PROSTHESIS, SILICONE OR EQUAL, WITH INTEGRAL ADHESIVE |
| L8032 |
NIPPLE PROSTHESIS, REUSABLE, ANY TYPE, EACH |
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| L8030 |
BREAST PROSTHESIS, SILICONE OR EQUAL |
BREAST PROSTHESIS, SILICONE OR EQUAL, WITHOUT INTEGRAL ADHESIVE |
Facial Prostheses
Added Code
| Code |
Narrative |
| A4456 |
ADHESIVE REMOVER, WIPES, ANY TYPE, EACH |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| A4365 |
ADHESIVE REMOVER WIPES, ANY TYPE, PER 50 |
A4456 |
Knee Orthoses
Added Code
| Code |
Narrative |
| A4466 |
GARMENT, BELT, SLEEVE OR OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE
MATERIAL, ANY TYPE, EACH (Note: Noncovered) |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| L1800 |
KNEE ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND
ADJUSTMENT |
A4466 |
| L1815 |
KNEE ORTHOSIS, ELASTIC OR OTHER ELASTIC TYPE MATERIAL WITH CONDYLAR PAD(S),
PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT |
A4466 |
| L1825 |
KNEE ORTHOSIS, ELASTIC KNEE CAP, PREFABRICATED, INCLUDES FITTING AND
ADJUSTMENT |
A4466 |
| L1901 |
ANKLE ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
(E.G. NEOPRENE, LYCRA) |
A4466 |
| L2770 |
ADDITION TO LOWER EXTREMITY ORTHOSIS, ANY MATERIAL - PER BAR OR JOINT |
None |
Lower Limb Prostheses
Added Code
| Code |
Narrative |
| L5973 |
ENDOSKELETAL ANKLE FOOT SYSTEM, MICROPROCESSOR CONTROLLED FEATURE, DORSIFLEXION
AND/OR PLANTAR FLEXION CONTROL, INCLUDES POWER SOURCE |
Miscellaneous
Added Code
| Code |
Narrative |
| A4466 |
GARMENT, BELT, SLEEVE OR OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE
MATERIAL, ANY TYPE, EACH (Note: Noncovered) |
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| E0700 |
SAFETY EQUIPMENT (E.G., BELT, HARNESS OR VEST) |
SAFETY EQUIPMENT, DEVICE OR ACCESSORY, ANY TYPE |
| E0249 |
PAD FOR WATER CIRCULATING HEAT UNIT |
PAD FOR WATER CIRCULATING HEAT UNIT, FOR REPLACEMENT ONLY |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| E1340 |
REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT REQUIRING
THE SKILL OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES (Note: Invalid
for claim submission to Medicare for DOS on/after 4/1/09) |
K0739 or K0740(Note: Effective 4/1/09) |
| L0210 |
THORACIC, RIB BELT |
A4466 |
| L3651 |
SHOULDER ORTHOSIS, SINGLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES
FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) |
A4466 |
| L3652 |
SHOULDER ORTHOSIS, DOUBLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES
FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) |
A4466 |
| L3700 |
ELBOW ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND
ADJUSTMENT |
A4466 |
| L3701 |
ELBOW ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
(E.G. NEOPRENE, LYCRA) |
A4466 |
| L3909 |
WRIST ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
(E.G. NEOPRENE, LYCRA) |
A4466 |
| L3911 |
WRIST HAND FINGER ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING
AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) |
A4466 |
| L6639 |
UPPER EXTREMITY ADDITION, HEAVY DUTY FEATURE, ANY ELBOW |
None |
Nebulizers
Added Code
| Code |
Narrative |
| Q4074 |
ILOPROST, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,
ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 20 MICROGRAMS |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| Q4080 |
ILOPROST, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED,
ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS |
Q4074 |
Ostomy Supplies
Added Code
| Code |
Narrative |
| A4456 |
ADHESIVE REMOVER, WIPES, ANY TYPE, EACH |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| A4365 |
ADHESIVE REMOVER WIPES, ANY TYPE, PER 50 |
A4456 |
Oxygen and Oxygen Equipment
Added Code
| Code |
Narrative |
| E0433 |
PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; HOME LIQUEFIER USED TO FILL PORTABLE
LIQUID OXYGEN CONTAINERS, INCLUDES PORTABLE CONTAINERS, REGULATOR, FLOWMETER,
HUMIDIFIER, CANNULA OR MASK AND TUBING, WITH OR WITHOUT SUPPLY RESERVOIR
AND CONTENTS GAUGE |
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| E0441 |
OXYGEN CONTENTS, GASEOUS (FOR USE WITH OWNED GASEOUS STATIONARY SYSTEMS
OR WHEN BOTH A STATIONARY AND PORTABLE GASEOUS SYSTEM ARE OWNED), 1 MONTH'S
SUPPLY = 1UNIT |
STATIONARY OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT |
| E0442 |
OXYGEN CONTENTS, LIQUID (FOR USE WITH OWNED LIQUID STATIONARY SYSTEMS
OR WHEN BOTH A STATIONARY AND PORTABLE GASEOUS SYSTEM ARE OWNED), 1 MONTH'S
SUPPLY = 1 UNIT |
STATIONARY OXYGEN CONTENTS, LIQUID, 1 MONTH'S SUPPLY = 1 UNIT |
| E0443 |
PORTABLE OXYGEN CONTENTS, GASEOUS (FOR USE ONLY WITH PORTABLE GASEOUS
SYSTEMS WHEN NO STATIONARY GAS OR LIQUID SYSTEM IS USED), 1 MONTH'S SUPPLY
= 1 UNIT |
PORTABLE OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT |
| E0444 |
PORTABLE OXYGEN CONTENTS, LIQUID (FOR USE ONLY WITH PORTABLE LIQUID SYSTEMS
WHEN NO STATIONARY GAS OR LIQUID SYSTEM IS USED), 1 MONTH'S SUPPLY = 1
UNIT |
PORTABLE OXYGEN CONTENTS, LIQUID, 1 MONTH'S SUPPLY = 1 UNIT |
Patient Lifts
Added Code
| Code |
Narrative |
| E1036 |
MULTI-POSITIONAL PATIENT TRANSFER SYSTEM, EXTRA-WIDE, WITH INTEGRATED
SEAT, OPERATED BY CAREGIVER, PATIENT WEIGHT CAPACITY GREATER THAN 300 LBS |
Spinal Orthoses
Added Code
| Code |
Narrative |
| A4466 |
GARMENT, BELT, SLEEVE OR OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE
MATERIAL, ANY TYPE, EACH (Note: Noncovered) |
Surgical Dressings
Narrative Changes
| Code |
Old Narrative |
New Narrative |
| A6549 |
GRADIENT COMPRESSION STOCKING, NOT OTHERWISE SPECIFIED (Note: Noncovered) |
GRADIENT COMPRESSION STOCKING/SLEEVE, NOT OTHERWISE SPECIFIED |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| A6200 |
COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER,
EACH DRESSING (Note: Invalid for claim submission to Medicare for DOS
on/after 1/1/07) |
A6251(Note: Effective 1/1/07) |
| A6201 |
COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL
TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING (Note: Invalid
for claim submission to Medicare for DOS on/after 1/1/07) |
A6252(Note: Effective 1/1/07) |
| A6202 |
COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER,
EACH DRESSING (Note: Invalid for claim submission to Medicare for DOS
on/after 1/1/07) |
A6253(Note: Effective 1/1/07) |
| A6542 |
GRADIENT COMPRESSION STOCKING, CUSTOM MADE |
A6549 |
| A6543 |
GRADIENT COMPRESSION STOCKING, LYMPHEDEMA |
A6549 |
Urological Supplies
Added Code
| Code |
Narrative |
| A4336 |
INCONTINENCE SUPPLY, URETHRAL INSERT, ANY TYPE, EACH |
| A4360 |
DISPOSABLE EXTERNAL URETHRAL CLAMP OR COMPRESSION DEVICE, WITH PAD AND/OR
POUCH, EACH (Note: Noncovered) |
| A4456 |
ADHESIVE REMOVER, WIPES, ANY TYPE, EACH |
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| A4365 |
ADHESIVE REMOVER WIPES, ANY TYPE, PER 50 |
A4456 |
Wheelchair Options and Accessories
Discontinued Code
| Code |
Narrative |
Crosswalk to Code |
| E2223 |
MANUAL WHEELCHAIR ACCESSORY, VALVE, ANY TYPE, REPLACEMENT ONLY, EACH |
None |
| E2393 |
POWER WHEELCHAIR ACCESSORY, VALVE FOR PNEUMATIC TIRE TUBE, ANY TYPE,
REPLACEMENT ONLY, EACH |
None |
| E2399 |
POWER WHEELCHAIR ACCESSORY, NOT OTHERWISE CLASSIFIED INTERFACE, INCLUDING
ALL RELATED ELECTRONICS AND ANY TYPE MOUNTING HARDWARE |
K0108 |
Modifiers
Added Modifiers
| Modifier |
Narrative |
| J4 |
DMEPOS ITEM SUBJECT TO DMEPOS COMPETITIVE BIDDING PROGRAM THAT IS FURNISHED
BY A HOSPITAL UPON DISCHARGE |
