HCPCS Level II changed and will be effective from 1st January 2017

HCPCS Level II changed and will be effective from 1st January 2017

There are more than 600 changes in HCPCS Level II, and many reflect the rise of MACRA’s (Medicare Access and CHIP Reauthorization Act) tracking and electronic medical records (EMR) initiatives. The codes will be effective from 1st January 2017. The codes include 278 new codes and modifiers. 145 codes will be discontinued. There are 147 codes whose descriptions have changed, and 37 with new payment rules. Code, S3854, has been reinstated. The changes are at least a third more than in a “usual” year.

A handful of description changes and new codes disrupt the A and E sections. Most changes are in the dynamic G code section. Of the 1,528 G codes, 213 are new and 108 are discontinued. Changes to descriptions or payment affected another 80 G codes. Reflecting the consolidation of quality programs resulting from the implementation of MACRA beginning January 1, 2017, most of the new codes help providers start tracking care for quality based payment boosts in 2019.

New injections for colchicine, argatroban, gatifloxacin, aripipazole lauroxil, and infliximab included in the J codes, which primarily report non-oral drugs. Several payment and BETOs changes are made in the J codes. Durable medical equipment codes in the K and L sections, along with the P codes remain unchanged.

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