CMS Releases Second Quarter 2024 HCPCS Level II Code Actions
CMS Releases Second Quarter 2024 HCPCS Level II Code Actions
CMS released a summary of the Second Quarter 2024 HCPCS Level II code requests and CMS’ coding decisions for each application. In most cases, these coding actions will take effect on October 1, 2024. Additionally, the decisions will be published in the October 2024 HCPCS Quarterly Update and will soon be available on the CMS website. Now is the time to study these changes and assess the impact on chargemaster and pharmacy management as well as applicable billing and coding activities.
Final Determinations for the Second Quarter 2024 Drug and Biological HCPCS Applications
A listing of CMS’ final coding decisions was released for each application. There were 20 new codes, one revised code description, and one deleted code, along with one deletion due to a transition from a C code to an A code. Applications included injectable drugs and protective barriers or covers for wounds and other disorders.
Details of each request and decision are available on the CMS document. A summary is included in the following table:
| Action | Title | HCPCS Code | Code Description | Comments |
| Revision | DOCIVYX | J9172 | Injection, docetaxel (avyxa) not therapeutically equivalent to j9171, 1 mg | Change of manufacturers |
| New | AURLUMYN™ | J1749 | Injection, iloprost, 0.1 mcg | Treatment of severe frostbite |
| New Delete 9/30/24 | XENOVIEW™ XENOVIEW™ | A9610 C9150 | Xenon xe-129 hyperpolarized gas, diagnostic, per study dose | Inhaled hyperpolarized contrast agent |
| New | COMBOGESIC® IV | J0138 | Injection, acetaminophen 10 mg and ibuprofen 3 mg | Pain relief and adjunct to opioid analgesics |
| Delete 9/30/24 | Paclitaxel Protein-Bound Particles for Injectable Suspension (albumin-bound) | J9258 | Injection, paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264, 1 mg | See CMS guidelines for AB-rated drugs in the Orange Book |
| New | JUBBONTI and WYOST | Q5136 | Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg | Increase bone mass and treat skeletal events in multiple myeloma and other tumors |
| New | TYENNE® | Q5135 | Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg | interleukin-6 (IL-6) receptor antagonist indicated for treatment of adult patients with moderate to severe active rheumatoid arthritis |
| New | TEVIMBRA | J9329 | Injection, tislelizumab-jsgr, 1 mg | Treatment of unresectable or metastatic esophageal squamous cell carcinoma |
| New | KISUNLA™ | J0175 | Injection, donanemab-azbt, 2 mg | Antibody used in treatment of Alzheimer’s disease |
| New | Baxter’s Vasopressin in Sodium Chloride Injection | J2601 | Injection, vasopressin (baxter), 1 unit | Increase blood pressure in adults with vasodilatory shock |
| New | Tri-Membrane Wrap™ | Q4344 | Tri-membrane wrap, per square centimeter | Barrier for chronic and active wounds |
| New | Dermacyte® AC Matrix Amniotic Membrane Allograft | Q4343 | Dermacyte ac matrix amniotic membrane allograft, per square centimeter | Protective covering or barrier |
| New | TheraMend | Q4342 | Theramend, per square centimeter | Patch wound covering |
| New | Matrix HD Allograft Dermis | Q4345 | Matrix hd allograft dermis, per square centimeter | Diabetic foot ulcers and burn wound cover |
| New | Artacent C | Q4336 | Artacent c, per square centimeter | Covering for acute and chronic wounds |
| New | Artacent Trident | Q4337 | Artacent trident, per square centimeter | Covering for acute and chronic wounds |
| New | Artacent Velos | Q4338 | Artacent velos, per square centimeter | Covering for acute and chronic wounds |
| New | Artacent VeriClen | Q4339 | Artacent vericlen, per square centimeter | Covering for acute and chronic wounds |
| New | AmnioPlast 1™ | Q4334 | Amnioplast 1, per square centimeter | Covering or barrier for ocular surface |
| New | AmnioPlast 2™ | Q4335 | Amnioplast 2, per square centimeter | Covering or barrier for ocular surface |
| New | SimpliMax | Q4341 | Simplimax, per square centimeter | Dual-layer Amniotic membrane used as a barrier for chronic and acute wounds |
| New | SimpliGraft | Q4340 | Simpligraft, per square centimeter | Single-layer Amniotic membrane used as a barrier for chronic and acute wounds |
HCPCS Level II Codes for Various FDA Approvals under the 505(b)(2) or Biologics License Application (BLA) Pathways and Products “Not Otherwise Classified”
CMS also reviewed codes for products approved under New Drug Application (NDA) or BLA pathways after October 2023. Refer to the CMS document for more information about these products and how they are rated and evaluated. As a result of CMS’ final HCPCS coding decisions, there are eight new, one revised, and four discontinued HCPCS Level II codes as listed below in Appendix A:
For the latest industry updates and detailed ICD-10 and CPT coding information, we encourage you to visit our ICD-10 and CPT Coding Resource Centers. Our resource centers provide comprehensive and up-to-date information to help you stay informed about the latest coding changes and guidelines. By accessing our valuable coding education training, you can stay further ahead in the healthcare industry.
