HCPCS Level II

HCPCS Level II 2018 code changes

Every HCPCS Level II code whose CMS add date or termination date falls in 2018, grouped by effective date. Each code's own page carries its full record.

186

Added

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 A deletion is listed on the first day the code is no longer valid (the day after its CMS termination date).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, 2018 (132)

C9014 — Injection, cerliponase alfa, 1 mg
C9015 — Injection, c-1 esterase inhibitor (human), haegarda, 10 units
C9016 — Injection, triptorelin extended release, 3.75 mg
C9024 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
C9028 — Injection, inotuzumab ozogamicin, 0.1 mg
C9029 — Injection, guselkumab, 1 mg
C9738 — Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)
C9748 — Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy
E0953 — Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each
E0954 — Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot
G0511 — Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month
G0512 — Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month
G0513 — Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
G0514 — Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
G0515 — Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
G0516 — Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
G0517 — Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
G0518 — Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
G9868 — Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes
G9869 — Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes
G9870 — Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes
G9892 — Documentation of patient reason(s) for not performing a dilated macular examination
G9893 — Dilated macular exam was not performed, reason not otherwise specified
G9894 — Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate
G9895 — Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy)
G9896 — Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate
G9897 — Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate, reason not given
G9898 — Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period
G9899 — Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed
G9900 — Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
G9901 — Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period
G9902 — Patient screened for tobacco use and identified as a tobacco user
G9903 — Patient screened for tobacco use and identified as a tobacco non-user
G9904 — Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)
G9905 — Patient not screened for tobacco use
G9906 — Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
G9907 — Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months (e.g., limited life expectancy, other medical reason)
G9908 — Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
G9909 — Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user (e.g., limited life expectancy, other medical reason)
G9910 — Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period
G9911 — Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy
G9912 — Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy
G9913 — Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not otherwise specified
G9914 — Patient initiated an anti-tnf agent
G9915 — No record of hbv results documented
G9916 — Functional status performed once in the last 12 months
G9917 — Documentation of advanced stage dementia and caregiver knowledge is limited
G9918 — Functional status not performed, reason not otherwise specified
G9919 — Screening performed and positive and provision of recommendations
G9920 — Screening performed and negative
G9921 — No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified
G9922 — Safety concerns screen provided and if positive then documented mitigation recommendations
G9923 — Safety concerns screen provided and negative
G9924 — Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)
G9925 — Safety concerns screening not provided, reason not otherwise specified
G9926 — Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources
G9927 — Documentation of system reason(s) for not prescribing an fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment
G9928 — Fda-approved anticoagulant not prescribed, reason not given
G9929 — Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)
G9930 — Patients who are receiving comfort care only
G9931 — Documentation of cha2ds2-vasc risk score of 0 or 1 for men; or 0, 1, or 2 for women
G9932 — Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)
G9933 — Adenoma(s) or colorectal cancer detected during screening colonoscopy
G9934 — Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
G9935 — Adenoma(s) or colorectal cancer not detected during screening colonoscopy
G9936 — Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus
G9937 — Diagnostic colonoscopy
G9938 — Patients aged 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period
G9939 — Pathologists/dermatopathologists is the same clinician who performed the biopsy
G9940 — Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)
G9941 — Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively
G9942 — Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
G9943 — Back pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
G9944 — Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
G9945 — Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
G9946 — Back pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
G9947 — Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively
G9948 — Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy
G9949 — Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively
G9954 — Patient exhibits 2 or more risk factors for post-operative vomiting
G9955 — Cases in which an inhalational anesthetic is used only for induction
G9956 — Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9957 — Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)
G9958 — Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively
G9959 — Systemic antimicrobials not prescribed
G9960 — Documentation of medical reason(s) for prescribing systemic antimicrobials
G9961 — Systemic antimicrobials prescribed
G9962 — Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy
G9963 — Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy
G9964 — Patient received at least one well-child visit with a pcp during the performance period
G9965 — Patient did not receive at least one well-child visit with a pcp during the performance period
G9966 — Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
G9967 — Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report
G9968 — Patient was referred to another clinician or specialist during the measurement period
G9969 — Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred
G9970 — Clinician who referred the patient to another clinician did not receive a report from the clinician to whom the patient was referred
G9974 — Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity
G9975 — Documentation of medical reason(s) for not performing a dilated macular examination
J0565 — Injection, bezlotoxumab, 10 mg
J0604 — Cinacalcet, oral, 1 mg, (for esrd on dialysis)
J0606 — Injection, etelcalcetide, 0.1 mg
J1428 — Injection, eteplirsen, 10 mg
J1555 — Injection, immune globulin (cuvitru), 100 mg
J1627 — Injection, granisetron, extended-release, 0.1 mg
J1726 — Injection, hydroxyprogesterone caproate, (makena), 10 mg
J1729 — Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
J2326 — Injection, nusinersen, 0.1 mg
J2350 — Injection, ocrelizumab, 1 mg
J3358 — Ustekinumab, for intravenous injection, 1 mg
J7210 — Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.
J7211 — Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
J7296 — Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg
J7345 — Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg
J9022 — Injection, atezolizumab, 10 mg
J9023 — Injection, avelumab, 10 mg
J9203 — Injection, gemtuzumab ozogamicin, 0.1 mg
J9285 — Injection, olaratumab, 10 mg
L3761 — Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf
L7700 — Gasket or seal, for use with prosthetic socket insert, any type, each
L8625 — External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each
L8694 — Auditory osseointegrated device, transducer/actuator, replacement only, each
P9073 — Platelets, pheresis, pathogen-reduced, each unit
P9100 — Pathogen(s) test for platelets
Q0477 — Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only
Q2040 — Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
Q4176 — Neopatch or therion, per square centimeter (add-on, list separately in addition to primary procedure)
Q4177 — Floweramnioflo, 0.1 cc
Q4178 — Floweramniopatch, per square centimeter (add-on, list separately in addition to primary procedure)
Q4179 — Flowerderm, per square centimeter (add-on, list separately in addition to primary procedure)
Q4180 — Revita, per square centimeter (add-on, list separately in addition to primary procedure)
Q4181 — Amnio wound, per square centimeter (add-on, list separately in addition to primary procedure)
Q4182 — Transcyte, per square centimeter (add-on, list separately in addition to primary procedure)

Deleted effective January 1, 2018 (37)

A9599 — Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified
C9140 — Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.
C9483 — Injection, atezolizumab, 10 mg
C9484 — Injection, eteplirsen, 10 mg
C9485 — Injection, olaratumab, 10 mg
C9486 — Injection, granisetron extended release, 0.1 mg
C9489 — Injection, nusinersen, 0.1 mg
C9490 — Injection, bezlotoxumab, 10 mg
C9491 — Injection, avelumab, 10 mg
C9494 — Injection, ocrelizumab, 1 mg
G0202 — Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
G0204 — Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
G0206 — Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
G0364 — Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of 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
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
G8696 — Antithrombotic therapy prescribed at discharge
G8697 — Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))
G8698 — Antithrombotic therapy was not prescribed at discharge, reason not given
G8879 — Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer
G8947 — One or more neuropsychiatric symptoms
G8971 — Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given
G8972 — One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
G9381 — Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period
G9496 — Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma
J1725 — Injection, hydroxyprogesterone caproate, 1 mg
J9300 — Injection, gemtuzumab ozogamicin, 5 mg
P9072 — Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unit
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

Added effective April 1, 2018 (28)

C9462 — Injection, delafloxacin, 1 mg
C9463 — Injection, aprepitant, 1 mg
C9464 — Injection, rolapitant, 0.5 mg
C9465 — Hyaluronan or derivative, durolane, for intra-articular injection, per dose
C9466 — Injection, benralizumab, 1 mg
C9467 — Injection, rituximab and hyaluronidase, 10 mg
C9468 — Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.
C9469 — Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
C9749 — Repair of nasal vestibular lateral wall stenosis with implant(s)
G9873 — First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
G9874 — Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
G9875 — Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions
G9876 — Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9
G9877 — Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12
G9878 — Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions.the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9
G9879 — Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12
G9880 — The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session
G9881 — The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session
G9882 — Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 13-15 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 13-15
G9883 — Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 16-18 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 16-18
G9884 — Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 19-21 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21
G9885 — Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 22-24 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24
G9890 — Bridge payment: a one-time payment for the first medicare diabetes prevention program (mdpp) core session, core maintenance session, or ongoing maintenance session furnished by an mdpp supplier to an mdpp beneficiary during months 1-24 of the mdpp expanded model (em) who has previously received mdpp services from a different mdpp supplier under the mdpp expanded model. a supplier may only receive one bridge payment per mdpp beneficiary
G9891 — Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only)
K0903 — For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
Q2041 — Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q5103 — Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
Q5104 — Injection, infliximab-abda, biosimilar, (renflexis), 10 mg

Deleted effective April 1, 2018 (1)

Q5102 — Injection, infliximab, biosimilar, 10 mg

Added effective July 1, 2018 (10)

C9030 — Injection, copanlisib, 1 mg
C9031 — Lutetium lu 177, dotatate, therapeutic, 1 mci
C9032 — Injection, voretigene neparvovec-rzyl, 1 billion vector genome
Q5105 — Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
Q5106 — Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
Q9991 — Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
Q9992 — Injection, buprenorphine extended-release (sublocade), greater than 100 mg
Q9993 — Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
Q9994 — In-line cartridge containing digestive enzyme(s) for enteral feeding, each
Q9995 — Injection, emicizumab-kxwh, 0.5 mg

Deleted effective July 1, 2018 (1)

C9469 — Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg

Added effective August 1, 2018 (1)

G2000 — Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session

Added effective October 1, 2018 (15)

C9033 — Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
C9034 — Injection, dexamethasone 9%, intraocular, 1 mcg
C9750 — Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation and peri-operative interrogation and programming; complete system (includes device and electrode)
G9978 — Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9979 — Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9980 — Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9981 — Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9982 — Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9983 — Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9984 — Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9985 — Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9986 — Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology
G9987 — Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code
Q5108 — Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
Q5110 — Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram

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 2018
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