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August 2020
Second-quarter HCPCS update: New codes added, deleted
The Centers for Medicare & Medicaid Services has added several new codes as part of its quarterly Health Care Procedure Coding System updates. The codes, effective dates and Blue Cross Blue Shield of Michigan’s coverage decisions are below.
Injections
| Code |
Change |
Coverage comments |
Effective date |
| J0223 |
Added |
Requires manual review |
July 1, 2020 |
| J0591 |
Added |
Not covered |
July 1, 2020 |
| J0691 |
Added |
Covered |
July 1, 2020 |
| J0742 |
Added |
Covered |
July 1, 2020 |
| J0791 |
Added |
Covered |
July 1, 2020 |
| J1201 |
Added |
Covered |
July 1, 2020 |
| J1429 |
Added |
Requires manual review |
July 1, 2020 |
| J1558 |
Added |
Covered |
July 1, 2020 |
| J3399 |
Added |
Requires manual review |
July 1, 2020 |
| J7333 |
Added |
Not covered |
July 1, 2020 |
| J9199 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| Q5121 |
Added |
Requires manual review |
July 1, 2020 |
Injections/chemotherapy
| Code |
Change |
Coverage comments |
Effective date |
| J0896 |
Added |
Requires manual review |
July 1, 2020 |
| J9177 |
Added |
Covered |
July 1, 2020 |
| J9198 |
Added |
Covered |
July 1, 2020 |
| J9246 |
Added |
Covered |
July 1, 2020 |
| J9358 |
Added |
Covered |
July 1, 2020 |
| Q5119 |
Added |
Covered |
July 1, 2020 |
| Q5120 |
Added |
Requires manual review |
July 1, 2020 |
Injections/anti-hemophilia drugs
| Code |
Change |
Coverage comments |
Effective date |
| J7169 |
Added |
Covered |
July 1, 2020 |
| J7204 |
Added |
Covered |
July 1, 2020 |
Outpatient Prospective Payment System/injection
| Code |
Change |
Coverage comments |
Effective date |
| C9059 |
Added |
Covered for facility only |
July 1, 2020 |
| C9061 |
Added |
Requires manual review |
July 1, 2020 |
| C9063 |
Added |
Covered for facility only |
July 1, 2020 |
| C9041 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9053 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9054 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9056 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9057 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9058 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
Outpatient Prospective Payment System/surgery
| Code |
Change |
Coverage comments |
Effective date |
| C9754 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9755 |
Deleted |
Deleted June 30, 2020 |
June 30, 2020 |
| C9759 |
Added |
Not covered |
June 30, 2020 |
| C9760 |
Added |
Requires manual review |
June 30, 2020 |
| C9764 |
Added |
Not covered |
July 1, 2020 |
| C9765 |
Added |
Not covered |
July 1, 2020 |
| C9766 |
Added |
Not covered |
July 1, 2020 |
| C9767 |
Added |
Not covered |
July 1, 2020 |
Outpatient Prospective Payment System/medical surgical supplies/devices/other implants
| Code |
Change |
Coverage comments |
Effective date |
| C7148 |
Added |
Covered for facility only |
July 1, 2020 |
Outpatient Prospective Payment System/medicine
| Code |
Change |
Coverage comments |
Effective date |
| C9122 |
Added |
Not covered |
July 1, 2020 |
Outpatient Prospective Payment System/radiology
| Code |
Change |
Coverage comments |
Effective date |
| C9762 |
Added |
Covered for facility only |
July 1, 2020 |
| C9763 |
Added |
Covered for facility only |
July 1, 2020 |
Outpatient Prospective Payment System/surgery/skin substitute
| Code |
Change |
Coverage comments |
Effective date |
| C1849 |
Added |
Not covered |
July 1, 2020 |
Surgery
| Code |
Change |
Coverage comments |
Effective date |
| G2170 |
Added |
Covered |
July 1, 2020 |
| G2171 |
Added |
Covered |
July 1, 2020 |
Skin substitute
| Code |
Change |
Coverage comments |
Effective date |
| Q4227 |
Added |
Not covered |
July 1, 2020 |
| Q4228 |
Added |
Not covered |
July 1, 2020 |
| Q4229 |
Added |
Not covered |
July 1, 2020 |
| Q4230 |
Added |
Not covered |
July 1, 2020 |
| Q4231 |
Added |
Not covered |
July 1, 2020 |
| Q4232 |
Added |
Not covered |
July 1, 2020 |
| Q4233 |
Added |
Not covered |
July 1, 2020 |
| Q4234 |
Added |
Not covered |
July 1, 2020 |
| Q4235 |
Added |
Not covered |
July 1, 2020 |
| Q4236 |
Added |
Not covered |
July 1, 2020 |
| Q4237 |
Added |
Not covered |
July 1, 2020 |
| Q4238 |
Added |
Not covered |
July 1, 2020 |
| Q4239 |
Added |
Not covered |
July 1, 2020 |
| Q4240 |
Added |
Not covered |
July 1, 2020 |
| Q4241 |
Added |
Not covered |
July 1, 2020 |
| Q4242 |
Added |
Not covered |
July 1, 2020 |
| Q4244 |
Added |
Not covered |
July 1, 2020 |
| Q4245 |
Added |
Not covered |
July 1, 2020 |
| Q4246 |
Added |
Not covered |
July 1, 2020 |
| Q4247 |
Added |
Not covered |
July 1, 2020 |
| Q4248 |
Added |
Not covered |
July 1, 2020 |
None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with all applicable state and federal laws and regulations.
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