Official Update to the HCPCS Code System
Medical coders use HCPCS codes to report medical procedures to Medicare, Medicaid, and several other third-party payors.HCPCS was developed by the Centers for Medicare and Medicaid (CMS) just as the AMA developed CPT for reporting medical procedures and services. Medical coders use HCPCS codes to report medical procedures to Medicare, Medicaid, and several other third-party payors.
The corrections to this code set released for 2016 are detailed below
HCPCS codes update Effective April 1, 2016
G Codes
Code G9490 – Joint replacement model – Home visit
Code G9481 – Remote in-home visit for the E & M of a new patient 10mins
Code G9482 – Remote in-home visit for the E & M of a new patient 20mins
Code G9483 – Remote in-home visit for the E & M of a new patient 30mins
Code G9484 – Remote in-home visit for the E & M of a new patient 45mins
Code G9485 – Remote in-home visit for the E & M of a new patient 60mins
Code G9486 – Remote in-home visit for the E & M of an established patient 10mins
Code G9487 – Remote in-home visit for the E & M of an established patient 15mins
Code G9488 – Remote in-home visit for the E & M of an established patient 25mins
Code G9489 – Remote in-home visit for the E & M of an established patient 45mins
Code G9678 – Oncology Care Model service
HCPCS code Effective July 1, 2016
Code C9458 – Replaced with HCPCS code Q9983 (Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries)
Code C9459 – Replaced with HCPCS code Q9982 (Flutemetamol F18, diagnostic, per study dose, up to 5 millicuries)
Code C9743 – Replaced with Category III CPT code 0438T (Transperineal placement of biodegradable material, peri-prostatic (via needle), single or multiple, includes image guidance)
New HCPCS codes
Q9981 – Rolapitant, Oral, 1mg
Q9982 – Flutemetamol F18, diagnostic, per study dose, up to 5 millicuries
Q9983 – Flutemetamol F18, diagnostic, per study dose, up to 8.1 millicuries
S0285 – Colonoscopy consultation performed prior to a screening colonoscopy procedure
S0311 – Comprehensive management and care coordination for advanced illness, per calendar month
S3854 – Gene expression profiling panel for use in the management of breast cancer treatment
Q5102 – Injection, Infliximab, Biosimilar, 10 mg
Modifier ZB – Pfizer / Hospira
New Hospital Outpatient Prospective Payment System (OPPS) passes through drug code
Code C9476 – Injection, daratumumab, 10 mg
Code C9477 – Injection, elotuzumab, 1 mg
Code C9478 – Injection, sebelipase alfa, 1 mg
Code C9479 – Instillation, ciprofloxacin otic suspension, 6 mg
Code C9480 – Injection, trabectedin, 0.1 mg
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