Coding highlights and other insight.
The HCPCS Level II code set used to report medical services and supplies will include 37 new codes effective April 1, 2022. Also in the second quarter update, five codes will be deleted and one modifier’s description will be revised.
Lay Terms for New Codes
Among the new codes being added to the HCPCS Level II code set in the second quarter are new codes requested by industry stakeholders during the Centers for Medicare & Medicaid Services (CMS) biannual HCPCS public meeting for code applications for non-drug and non-biological items and services, Dec. 1-2, 2021.
Code requests are not finalized at these public meetings, but you can learn a lot about why a code was approved or denied by reviewing the meeting agendas. For example, new codes:
K1028 Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive sleep apnea, controlled by phone application
K1029 Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply
These are the result of Signifier Medical Technologies, LLC (SMT) submitting a request to establish a new code to identify the eXciteOSA durable control unit — a tongue neuromuscular stimulation device used to treat mild obstructive sleep apnea (AHI 5-15). “No HCPCS codes currently exist to describe a tongue neuromuscular stimulation device for OSA,” SMT contended. SMT also requested a new code for the disposable mouthpiece (K1029).
The California Department of Healthcare Services also submitted a request for CMS to establish codes to identify skills training and development; financial management, self-directed, waiver; and supports brokerage, self-directed.
“These codes support the enhanced benefits under the Medi-Cal managed care program known as In Lieu of Services, which are medically appropriate and cost-effective alternatives to services that can be covered in the State Plan,” according to the state agency.
The resulting new codes are:
H2038 Skills training and development, per diem
T2050 Financial management, self-directed, waiver; per diem
T2051 Supports brokerage, self-directed, waiver; per diem
Koya Medical, Inc. submitted a request for revising HCPCS Level II codes E0651 (and E0667, E0669). “The existing code descriptor restricts the method of compression to ‘pneumatic,’” Koya said. Instead of revising the descriptors for E0651, E0667, and E0669, CMS created new codes for non-pneumatic compressors for the treatment of fluid collection (lymphedema) in the legs.
K1031 Non-pneumatic compression controller without calibrated gradient pressure
K1032 Non-pneumatic sequential compression garment, full leg
K1033 Non-pneumatic sequential compression garment, half leg
Last year, Koya submitted a similar request for a non-pneumatic compression control with calibrated gradient pressure (K1024) and compression garment for the full arm (K1025).
PolyMedics Innovations Inc. (PMI) requested a new code to identify the Supra SDRM and Suprathel — resorbable synthetic skin substitutes “used to treat epidermal and dermal wounds, including those caused by burns, pressure ulcers, and venous ulcers, among other wounds,” PMI explained. “While HCPCS code C1849 (Skin substitute, synthetic, resorbable, per square centimeter) may be used to report [these products] when used in the hospital outpatient department, there is no existing HCPCS Q code that describes [these products] when used in the physician office setting.”
Beginning April 1, you will have the following codes to report these supplies:
A2011 Supra sdrm, per square centimeter
A2012 Suprathel, per square centimeter
Triad Life Sciences, Inc. requested a code for InnovaMatrix FS — “a sterile, single use, medical device consisting of extracellular matrix derived from porcine placental material used for safe and effective wound treatment,” the company explained.
Beginning April 1, you will use the following code to report InnovaMatrix FX:
A2013 Innovamatrix fs, per square centimeter
HCPCS Level II Deletions and Revisions Effective Q2
The five deleted codes include chemotherapy injection codes C9084-C9087 and clinical decision support mechanism code G1009.
Also, the descriptor for modifier FT is revised to clarify its use is to identify a service that is unrelated to an evaluation and management (E/M) visit during a global procedure:
Unrelated evaluation and management (e/m) visit on the same day as another e/m visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated)
For More Information: https://www.aapc.com/blog/84278-cms-updates-hcpcs-level-ii-for-q2/