The new year is right around the corner, and that means that it’s nearly time for the newest edition of the Healthcare Common Procedure Coding System (HCPCS) Level II codes to go into effect. Released November 6th, this latest updates encompasses a full 327 changes across numerous aspects of the system.
As part of the update, HCPCS is introducing 11 new modifiers, two of which (JG and TB) are designed to track 340b drug pricing in response to the recent announcement that CMS would be lowering their reimbursement for drugs in this category. The others will be used to support radiology or quality care initiatives. On the flip side, two modifiers will be deleted: CP (Adjunctive service assigned to an APC but reported on a different claim) and SZ (Habilitative services).
Of the 327 total changes, 153 of them are new codes, including 89 solely for the G code category of screening, documentation, exams, and services. Other categories that will be seeing significant upgrades include the C section with 14 new drug or pass-through codes, J section with 19 new drugs codes, Q section with nine new dermal graft and pneumatic assist device codes, K and L sections with six new codes for glucose monitors, prosthetics, orthotics, and cochlear implants, and P section with two new codes concerning platelets.
A full 52 changed codes and modifiers will go into effect, including two modifiers for tracking how services are billed in medically underserved areas and 36 changes to G codes that cover quality measures and the testing of gene mutations. Several codes have also been permanently deleted, including some of those for radio-pharmaceuticals, injections, mammographies, antithrombotic therapy, neuropsychiatric symptoms, end-of-life issues, breast cancer, and neoplasms.
If you want to make sure that you have the updated 2018 codes ready at your fingertips, preordering the latest code book through MMI is the perfect way to make sure you have all the knowledge you need to succeed in the coding world.