Each year in the first quarter, the HCPCS Level II code set is refreshed with several new, revised, and deleted codes. CMS explains Level II of the HCPCS as a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT-4 codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office. In 2022 too, CMS has released the HCPCS Level II coding update with 155 new codes, 63 revised codes, and 48 deleted codes, effective January 1, 2022. Professional medical coding companies will assign the right codes on the medical claims, based on specific payer policies and the National Correct Coding Initiative file for coverage indictors.

Here’s a list of some of the new, deleted and revised codes.

New Codes

Some of the new codes discussed in the CMS’ HCPCS Application Summary are –

  • A9595 Piflufolastat f-18, diagnostic, 1 millicurie
  • Q4199 Cygnus matrix, per square centimeter

(This code is for “use as a wound covering or barrier in surgical, orthopedic, ophthalmic and wound applications”)

  • J9061 Injection, amivantamab-vmjw, 2 mg

(This code will replace HCPCS Level II code C9083 (Injection, amivantamab-vmjw, 10 mg), which was discontinued on December 31.)

  • J9021 Injection, asparaginase, recombinant, (rylaze), 0.1 mg

(Rylaze is indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) in adult and pediatric patients)

  • J9272 Injection, dostarlimab-gxly, 10 mg

(This code will replace C9082, which was discontinued on Dec. 31)

  • J1952 Leuprolide injectable, camcevi, 1 mg

(New code to report Camcevi® – indicated for the treatment of adult patients with advanced prostate cancer)

  • J0172 Injection, aducanumab-avwa, 2 mg

(Used to identify ADUHELM® for the treatment of Alzheimer’s disease)

  • Q2055 Idecabtagenevicleucel, up to 460 million autologous b-cell maturation antigen (bcma) directed CAR-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

(Used to identify ABECMA®, which is a B-cell maturation antigen (BCMA)-directed genetically modified autologous cell immunotherapy)

Other new codes include the following.

  • A2002 Mirragen advanced wound matrix, per square centimeter
  • C1832 Autograft suspension, including cell processing and application, and all system components
  • E1629 Tablo hemodialysis system for the billable dialysis service
  • G0031 Palliative care services given to patient any time during the measurement period
  • G1025 Patient-months where there are more than one Medicare capitated payment (mcp) provider listed for the month
  • G4026 Physical therapy/occupational therapy MIPS specialty set
  • G9996 Documentation stating the patient has received or is currently receiving palliative or hospice care

Two new HCPCS Level II codes, effective April 1, 2021 are –

  • G0465 Autologous platelet rich plasma (PRP) for diabetic chronic wounds/ulcers, using an FDA-cleared device (includes administration, dressings, phlebotomy, centrifugation, and all other preparatory procedures, per treatment)
  • G0460 Autologous platelet rich plasma for non-diabetic chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment

Deleted Codes

  • C9752 Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum
  • G0424 Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day
  • G9267 Documentation of patient with one or more complications or mortality within 30 days
  • G9349 Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
  • G9578 Documentation of signed opioid treatment agreement at least once during opioid therapy
  • M1022 Patients who were in hospice at any time during the performance period

Revised Codes with Long Description Changes

  • G2121 Depression, anxiety, apathy, and psychosis assessed
  • G2148 Multimodal pain management was used
  • G2174 Uri episodes when the patient had an active prescription of antibiotics (table 1) in the 30 days prior to the episode date
  • G2177 Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to the episode date
  • G2215 Take-home supply of nasal naloxone; 2-pack of 4mg per 0.1 ml nasal spray (provision of the services by a Medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure
  • G9359 Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifier
  • G9780 Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period
  • G9822 Patients who had an endometrial ablation procedure during the 12 months prior to the index date (exclusive of the index date)
  • G9928 FDA-approved anticoagulant not prescribed, reason not given

As CPT, ICD and HCPCS coding updates happen each year, it is important for healthcare practices to be up-to-date with the changing coding and billing guidelines. Providers can rely on medical coding outsourcing services to submit clean claims to insurers, and thus ensure on-time reimbursement.