HCPCS Level II

HCPCS Level II 2017 code changes

Every HCPCS Level II code whose CMS add date or termination date falls in 2017, grouped by effective date. Each code's own page carries its full record.

267

Added

143

Deleted

For HCPCS Level II, MedCoder records each code's CMS add date and termination date from the alpha-numeric file. A deletion is listed on the first day the code is no longer valid (the day after its CMS termination date). Description revisions between quarterly files are not recorded as changes.

Added effective January 1, 2017 (245)

A4224 — Supplies for maintenance of insulin infusion catheter, per week
A4225 — Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
A4467 — Belt, strap, sleeve, garment, or covering, any type
A4553 — Non-disposable underpads, all sizes
A9285 — Inversion/eversion correction device
A9286 — Hygienic item or device, disposable or non-disposable, any type, each
A9515 — Choline c-11, diagnostic, per study dose up to 20 millicuries
A9587 — Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
A9588 — Fluciclovine f-18, diagnostic, 1 millicurie
A9597 — Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
A9598 — Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified
C1842 — Retinal prosthesis, includes all internal and external components; add-on to c1841
C1889 — Implantable/insertable device, not otherwise classified
C9140 — Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.
G0491 — Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd
G0492 — Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd
G0493 — Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0494 — Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0495 — Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0496 — Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0500 — Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
G0501 — Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)
G0502 — Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies
G0503 — Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment
G0504 — Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)
G0505 — Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
G0506 — Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
G0507 — Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team
G0508 — Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
G0509 — Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
G0659 — Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes
G9687 — Hospice services provided to patient any time during the measurement period
G9688 — Patients using hospice services any time during the measurement period
G9689 — Patient admitted for performance of elective carotid intervention
G9690 — Patient receiving hospice services any time during the measurement period
G9691 — Patient had hospice services any time during the measurement period
G9692 — Hospice services received by patient any time during the measurement period
G9693 — Patient use of hospice services any time during the measurement period
G9694 — Hospice services utilized by patient any time during the measurement period
G9695 — Long-acting inhaled bronchodilator prescribed
G9696 — Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., patient intolerance or history of side effects)
G9697 — Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator
G9698 — Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator (e.g., cost of treatment or lack of insurance)
G9699 — Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified
G9700 — Patients who use hospice services any time during the measurement period
G9701 — Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established
G9702 — Patients who use hospice services any time during the measurement period
G9703 — Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
G9704 — Ajcc breast cancer stage i: t1 mic or t1a documented
G9705 — Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented
G9706 — Low (or very low) risk of recurrence, prostate cancer
G9707 — Patient received hospice services any time during the measurement period
G9708 — Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
G9709 — Hospice services used by patient any time during the measurement period
G9710 — Patient was provided hospice services any time during the measurement period
G9711 — Patients with a diagnosis or past history of total colectomy or colorectal cancer
G9712 — Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis
G9713 — Patients who use hospice services any time during the measurement period
G9714 — Patient is using hospice services any time during the measurement period
G9715 — Patients who use hospice services any time during the measurement period
G9716 — Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
G9717 — Documentation stating the patient has had a diagnosis of bipolar disorder
G9718 — Hospice services for patient provided any time during the measurement period
G9719 — Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9720 — Hospice services for patient occurred any time during the measurement period
G9721 — Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
G9722 — Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher
G9723 — Hospice services for patient received any time during the measurement period
G9724 — Patients who had documentation of use of anticoagulant medications overlapping the measurement year
G9725 — Patients who use hospice services any time during the measurement period
G9726 — Patient refused to participate
G9727 — Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9728 — Patient refused to participate
G9729 — Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9730 — Patient refused to participate
G9731 — Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9732 — Patient refused to participate
G9733 — Patient unable to complete the low back fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9734 — Patient refused to participate
G9735 — Patient unable to complete the shoulder fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9736 — Patient refused to participate
G9737 — Patient unable to complete the elbow/wrist/hand fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9738 — Patient refused to participate
G9739 — Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available
G9740 — Hospice services given to patient any time during the measurement period
G9741 — Patients who use hospice services any time during the measurement period
G9742 — Psychiatric symptoms assessed
G9743 — Psychiatric symptoms not assessed, reason not otherwise specified
G9744 — Patient not eligible due to active diagnosis of hypertension
G9745 — Documented reason for not screening or recommending a follow-up for high blood pressure
G9746 — Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)
G9747 — Patient is undergoing palliative dialysis with a catheter
G9748 — Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
G9749 — Patient is undergoing palliative dialysis with a catheter
G9750 — Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant
G9751 — Patient died at any time during the 24-month measurement period
G9752 — Emergency surgery
G9753 — Documentation of medical reason for not conducting a search for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence)
G9754 — A finding of an incidental pulmonary nodule
G9755 — Documentation of medical reason(s) for not including a recommended interval and modality for follow-up or for no follow-up, and source of recommendations (e.g., patients with unexplained fever, immunocompromised patients who are at risk for infection)
G9756 — Surgical procedures that included the use of silicone oil
G9757 — Surgical procedures that included the use of silicone oil
G9758 — Patient in hospice at any time during the measurement period
G9759 — History of preoperative posterior capsule rupture
G9760 — Patients who use hospice services any time during the measurement period
G9761 — Patients who use hospice services any time during the measurement period
G9762 — Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays
G9763 — Patient did not have at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays
G9764 — Patient has been treated with a systemic medication for psoriasis vulgaris
G9765 — Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi
G9766 — Patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment
G9767 — Hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment
G9768 — Patients who utilize hospice services any time during the measurement period
G9769 — Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months
G9770 — Peripheral nerve block (pnb)
G9771 — At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time
G9772 — Documentation of medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.)
G9773 — At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or 15 minutes immediately after anesthesia end time, reason not given
G9774 — Patients who have had a hysterectomy
G9775 — Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9776 — Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
G9777 — Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9778 — Patients who have a diagnosis of pregnancy at any time during the measurement period
G9779 — Patients who are breastfeeding at any time during the performance period
G9780 — Patients who have a diagnosis of rhabdomyolysis at any time during the performance period
G9781 — Documentation of medical reason(s) for not currently being a statin therapy user or receiving an order (prescription) for statin therapy (e.g., patients with statin-associated muscle symptoms or an allergy to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease [esrd], or other medical reasons)
G9782 — History of or active diagnosis of familial hypercholesterolemia
G9783 — Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy
G9784 — Pathologists/dermatopathologists providing a second opinion on a biopsy
G9785 — Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist
G9786 — Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) was not sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist
G9787 — Patient alive as of the last day of the measurement year
G9788 — Most recent bp is less than or equal to 130/80 mm hg
G9789 — Blood pressure recorded during inpatient stays, emergency room visits, or urgent care visits
G9790 — Most recent bp is greater than 130/80 mm hg, or blood pressure not documented
G9791 — Most recent tobacco status is tobacco free
G9792 — Most recent tobacco status is not tobacco free
G9793 — Patient is currently on a daily aspirin or other antiplatelet
G9794 — Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)
G9795 — Patient is not currently on a daily aspirin or other antiplatelet
G9796 — Patient is currently on a high intensity statin therapy
G9797 — Patient is not on a high intensity statin therapy
G9798 — Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period
G9799 — Patients with a medication dispensing event indicator of a history of asthma any time during the patient's history through the end of the measure period
G9800 — Patients who are identified as having an intolerance or allergy to beta-blocker therapy
G9801 — Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis
G9802 — Patients who use hospice services any time during the measurement period
G9803 — Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
G9804 — Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
G9805 — Patients who use hospice services any time during the measurement period
G9806 — Patients who received cervical cytology or an hpv test
G9807 — Patients who did not receive cervical cytology or an hpv test
G9808 — Any patients who had no asthma controller medications dispensed during the measurement year
G9809 — Patients who use hospice services any time during the measurement period
G9810 — Patient achieved a pdc of at least 75% for their asthma controller medication
G9811 — Patient did not achieve a pdc of at least 75% for their asthma controller medication
G9812 — Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure
G9813 — Patient did not die within 30 days of the procedure or during the index hospitalization
G9814 — Death occurring during the index acute care hospitalization
G9815 — Death did not occur during the index acute care hospitalization
G9816 — Death occurring after discharge from the hospital but within 30 days post procedure
G9817 — Death did not occur after discharge from the hospital within 30 days post procedure
G9818 — Documentation of sexual activity
G9819 — Patients who use hospice services any time during the measurement period
G9820 — Documentation of a chlamydia screening test with proper follow-up
G9821 — No documentation of a chlamydia screening test with proper follow-up
G9822 — Patients who had an endometrial ablation procedure during the 12 months prior to the index date (exclusive of the index date)
G9823 — Endometrial sampling or hysteroscopy with biopsy and results documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation
G9824 — Endometrial sampling or hysteroscopy with biopsy and results not documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation
G9825 — Her-2/neu negative or undocumented/unknown
G9826 — Patient transferred to practice after initiation of chemotherapy
G9827 — Her2-targeted therapies not administered during the initial course of treatment
G9828 — Her2-targeted therapies administered during the initial course of treatment
G9829 — Breast adjuvant chemotherapy administered
G9830 — Her-2/neu positive
G9831 — Ajcc stage at breast cancer diagnosis = ii or iii
G9832 — Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis = t1c
G9833 — Patient transfer to practice after initiation of chemotherapy
G9834 — Patient has metastatic disease at diagnosis
G9835 — Trastuzumab administered within 12 months of diagnosis
G9836 — Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
G9837 — Trastuzumab not administered within 12 months of diagnosis
G9838 — Patient has metastatic disease at diagnosis
G9839 — Anti-egfr monoclonal antibody therapy
G9840 — Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab
G9841 — Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab
G9842 — Patient has metastatic disease at diagnosis
G9843 — Ras (kras or nras) gene mutation
G9844 — Patient did not receive anti-egfr monoclonal antibody therapy
G9845 — Patient received anti-egfr monoclonal antibody therapy
G9846 — Patients who died from cancer
G9847 — Patient received systemic cancer-directed therapy in the last 14 days of life
G9848 — Patient did not receive systemic cancer-directed therapy in the last 14 days of life
G9849 — Patients who died from cancer
G9850 — Patient had more than one emergency department visit in the last 30 days of life
G9851 — Patient had one or less emergency department visits in the last 30 days of life
G9852 — Patients who died from cancer
G9853 — Patient admitted to the icu in the last 30 days of life
G9854 — Patient was not admitted to the icu in the last 30 days of life
G9855 — Patients who died from cancer
G9856 — Patient was not admitted to hospice
G9857 — Patient admitted to hospice
G9858 — Patient enrolled in hospice
G9859 — Patients who died from cancer
G9860 — Patient spent less than three days in hospice care
G9861 — Patient spent greater than or equal to three days in hospice care
G9862 — Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)
J0570 — Buprenorphine implant, 74.2 mg
J0883 — Injection, argatroban, 1 mg (for non-esrd use)
J0884 — Injection, argatroban, 1 mg (for esrd on dialysis)
J1130 — Injection, diclofenac sodium, 0.5 mg
J1942 — Injection, aripiprazole lauroxil, 1 mg
J2182 — Injection, mepolizumab, 1 mg
J2786 — Injection, reslizumab, 1 mg
J2840 — Injection, sebelipase alfa, 1 mg
J7175 — Injection, factor x, (human), 1 i.u.
J7179 — Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco
J7202 — Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.
J7207 — Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.
J7209 — Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.
J7320 — Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
J7322 — Hyaluronan or derivative, hymovis or hymovis one, for intra-articular injection, 1 mg
J7342 — Instillation, ciprofloxacin otic suspension, 6 mg
J8670 — Rolapitant, oral, 1 mg
J9034 — Injection, bendamustine hcl (bendeka), 1 mg
J9145 — Injection, daratumumab, 10 mg
J9176 — Injection, elotuzumab, 1 mg
J9205 — Injection, irinotecan liposome, 1 mg
J9295 — Injection, necitumumab, 1 mg
J9325 — Injection, talimogene laherparepvec, per 1 million plaque forming units
J9352 — Injection, trabectedin, 0.1 mg
L1851 — Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
L1852 — Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Q4166 — Cytal, per square centimeter (add-on, list separately in addition to primary procedure)
Q4167 — Truskin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4168 — Amnioband, 1 mg
Q4169 — Artacent wound, per square centimeter (add-on, list separately in addition to primary procedure)
Q4170 — Cygnus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4171 — Interfyl, 1 mg
Q4172 — Puraply or puraply am, per square centimeter
Q4173 — Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure)
Q4174 — Palingen or promatrx, 0.36 mg per 0.25 cc
Q4175 — Miroderm, per square centimeter (add-on, list separately in addition to primary procedure)
T1040 — Medicaid certified community behavioral health clinic services, per diem
T1041 — Medicaid certified community behavioral health clinic services, per month

Deleted effective January 1, 2017 (142)

A4466 — Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each
A9544 — Iodine i-131 tositumomab, diagnostic, per study dose
A9545 — Iodine i-131 tositumomab, therapeutic, per treatment dose
B9000 — Enteral nutrition infusion pump - without alarm
C9121 — Injection, argatroban, per 5 mg
C9137 — Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.
C9138 — Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.
C9139 — Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.
C9349 — Puraply, and puraply antimicrobial, any type, per square centimeter
C9461 — Choline c 11, diagnostic, per study dose
C9470 — Injection, aripiprazole lauroxil, 1 mg
C9471 — Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg
C9472 — Injection, talimogene laherparepvec, 1 million plaque forming units (pfu)
C9473 — Injection, mepolizumab, 1 mg
C9474 — Injection, irinotecan liposome, 1 mg
C9475 — Injection, necitumumab, 1 mg
C9476 — Injection, daratumumab, 10 mg
C9477 — Injection, elotuzumab, 1 mg
C9478 — Injection, sebelipase alfa, 1 mg
C9479 — Instillation, ciprofloxacin otic suspension, 6 mg
C9480 — Injection, trabectedin, 0.1 mg
C9481 — Injection, reslizumab, 1 mg
C9742 — Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed
C9800 — Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies
E0628 — Separate seat lift mechanism for use with patient owned furniture-electric
G0163 — Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
G0164 — Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
G0389 — Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening
G0477 — Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
G0478 — Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
G0479 — Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service
G3001 — Administration and supply of tositumomab, 450 mg
G8401 — Clinician documented that patient was not an eligible candidate for screening
G8458 — Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)
G8460 — Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c
G8461 — Patient receiving antiviral treatment for hepatitis c during the measurement period
G8485 — I intend to report the diabetes mellitus (dm) measures group
G8486 — I intend to report the preventive care measures group
G8487 — I intend to report the chronic kidney disease (ckd) measures group
G8489 — I intend to report the coronary artery disease (cad) measures group
G8490 — I intend to report the rheumatoid arthritis (ra) measures group
G8491 — I intend to report the hiv/aids measures group
G8494 — All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient
G8495 — All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient
G8496 — All quality actions for the applicable measures in the preventive care measures group have been performed for this patient
G8497 — All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient
G8498 — All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient
G8499 — All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient
G8500 — All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient
G8544 — I intend to report the coronary artery bypass graft (cabg) measures group
G8545 — I intend to report the hepatitis c measures group
G8548 — I intend to report the heart failure (hf) measures group
G8549 — All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient
G8551 — All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient
G8634 — Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis
G8645 — I intend to report the asthma measures group
G8646 — All quality actions for the applicable measures in the asthma measures group have been performed for this patient
G8725 — Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)
G8726 — Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
G8728 — Fasting lipid profile not performed, reason not given
G8757 — All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient
G8758 — All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient
G8759 — All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient
G8761 — All quality actions for the applicable measures in the dementia measures group have been performed for this patient
G8762 — All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient
G8765 — All quality actions for the applicable measures in the cataract measures group have been performed for this patient
G8784 — Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)
G8848 — Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)
G8853 — Positive airway pressure therapy not prescribed
G8868 — Patients receiving a first course of anti-tnf therapy
G8898 — I intend to report the chronic obstructive pulmonary disease (copd) measures group
G8899 — I intend to report the inflammatory bowel disease (ibd) measures group
G8900 — I intend to report the sleep apnea measures group
G8902 — I intend to report the dementia measures group
G8903 — I intend to report the parkinson's disease measures group
G8906 — I intend to report the cataract measures group
G8927 — Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer
G8928 — Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
G8929 — Adjuvant chemotherapy not prescribed or previously received, reason not given
G8940 — Screening for depression documented as positive, a follow-up plan not completed, documented reason
G8948 — No neuropsychiatric symptoms
G8953 — All quality actions for the applicable measures in the oncology measures group have been performed for this patient
G8977 — I intend to report the oncology measures group
G9203 — Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
G9204 — Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
G9205 — Patient starting antiviral treatmentfor hepatitis c during the measurement period
G9206 — Patient starting antiviral treatment for hepatitis c during the measurement period
G9207 — Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c
G9208 — Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given
G9209 — Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment
G9210 — Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)
G9211 — Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given
G9217 — Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given
G9219 — Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)
G9222 — Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3
G9233 — All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient
G9234 — I intend to report the total knee replacement measures group
G9235 — All quality actions for the applicable measures in the general surgery measures group have been performed for this patient
G9236 — All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient
G9237 — I intend to report the general surgery measures group
G9238 — I intend to report the optimizing patient exposure to ionizing radiation measures group
G9244 — Antiretroviral thereapy not prescribed
G9245 — Antiretroviral therapy prescribed
G9324 — All necessary data elements not included, reason not given
G9435 — Aspirin prescribed at discharge
G9436 — Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
G9437 — Aspirin not prescribed at discharge
G9438 — P2y inhibitor prescribed at discharge
G9439 — P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)
G9440 — P2y inhibitor not prescribed at discharge
G9441 — Statin prescribed at discharge
G9442 — Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)
G9443 — Statin not prescribed at discharge
G9463 — I intend to report the sinusitis measures group
G9464 — All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient
G9465 — I intend to report the acute otitis externa (aoe) measures group
G9466 — All quality actions for the applicable measures in the aoe measures group have been performed for this patient
G9467 — Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months
G9499 — Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period
G9572 — Index date phq-score greater than 9 documented during the twelve month denominator identification period
G9581 — Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment)
G9619 — Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)
G9650 — Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi
G9652 — Patient has been treated with a systemic or biologic medication for psoriasis for at least six months
G9653 — Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months
G9657 — Transfer of care during an anesthetic or to the intensive care unit
G9667 — Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)
G9669 — I intend to report the multiple chronic conditions measures group
G9670 — All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient
G9671 — I intend to report the diabetic retinopathy measures group
G9672 — All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient
G9673 — I intend to report the cardiovascular prevention measures group
G9677 — All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient
J0760 — Injection, colchicine, per 1 mg
J1590 — Injection, gatifloxacin, 10 mg
K0901 — Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
K0902 — Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Q4119 — Matristem wound matrix, per square centimeter
Q4120 — Matristem burn matrix, per square centimeter
Q4129 — Unite biomatrix, per square centimeter
Q9980 — Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg
Q9981 — Rolapitant, oral, 1 mg

Added effective April 1, 2017 (5)

C9484 — Injection, eteplirsen, 10 mg
C9485 — Injection, olaratumab, 10 mg
C9486 — Injection, granisetron extended release, 0.1 mg
C9487 — Ustekinumab, for intravenous injection, 1 mg
C9488 — Injection, conivaptan hydrochloride, 1 mg

Added effective July 1, 2017 (13)

C9489 — Injection, nusinersen, 0.1 mg
C9490 — Injection, bezlotoxumab, 10 mg
C9745 — Nasal endoscopy, surgical; balloon dilation of eustachian tube
C9746 — Transperineal implantation of permanent adjustable balloon continence device, with cystourethroscopy, when performed and/or fluoroscopy, when performed
C9747 — Ablation of prostate, transrectal, high intensity focused ultrasound (hifu), including imaging guidance
K0553 — Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
K0554 — Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
Q9984 — Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg
Q9985 — Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
Q9986 — Injection, hydroxyprogesterone caproate, (makena), 10 mg
Q9987 — Pathogen(s) test for platelets
Q9988 — Platelets, pheresis, pathogen-reduced, each unit
Q9989 — Ustekinumab, for intravenous injection, 1 mg

Deleted effective July 1, 2017 (1)

C9487 — Ustekinumab, for intravenous injection, 1 mg

Added effective October 1, 2017 (4)

C9491 — Injection, avelumab, 10 mg
C9492 — Injection, durvalumab, 10 mg
C9493 — Injection, edaravone, 1 mg
C9494 — Injection, ocrelizumab, 1 mg

Source: CMS HCPCS Level II alpha-numeric file (add and termination dates).

Source data

Source organization: CMS
Source release: HCPCS Level II October 2026 alpha-numeric file
Source file: october-2026-alpha-numeric-hcpcs-file.zip
File checksum (SHA-256): c25240c63108756d4ba6c0ea785c517117d83bfed9526c51da8acf123de1feb6
Data read date: Data not available in the current MedCoder release record.
Effective date: CMS effective dates within 2017
Release type: Quarterly (January, April, July, October), with occasional mid-quarter additions
Methodology: Each code's add date and termination date are read from the alpha-numeric file. A deletion is dated the first day the code is no longer valid, the day after its termination date. Description revisions are not recorded as changes.

These changes are based on recorded release data. MedCoder does not generate coding changes with AI.

All releases in the Change Ledger