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Official Update to the HCPCS Code System

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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) pass 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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