2020 Part A MAC Update

2020 Annual Update:
The SNF consolidated billing file reflects new codes that have been developed for 2020. In addition, the file reflects additions to categories of services excluded from consolidated billing.


The annual update file below contains the complete list of HCPCS codes that are excluded from SNF CB for claims submitted to Part A MACs for payment. Minor Surgery and Part B therapy inclusions are also included with this file. This file is effective for claims with dates of service on or after 1/1/2020 unless otherwise noted below.


Major Category III. A. – Chemotherapy retroactive to October 1, 2019 :
ADD-J0641-Inj.,levoleucorvin, nos, 0,5mg
ADD-J0642-Inj., levoeucorvin, khapzory, 0,5mg

Effective January 1, 2020:
ADD-J9030-Bcg live intravesical 1mg
ADD-J9036-Inj. belrapzo/bendamustine
ADD-J9118-Inj. Calaspargase pegol-mknl
ADD-J9119-Inj., cemiplimab-rwlc, 1 mg
ADD-J9269-Inj. tagraxofusp-erzs 10 mcg
ADD-J9313-Inj., lumoxiti, 0.01 mg


REVISE-J9355-Inj trastuzumab excl biosimi
ADD-J9356-Inj. herceptin hylecta, 10mg
ADD-Q5112-Inj ontruzant 10 mg
ADD-Q5113-Inj herzuma 10 mg
ADD-Q5114-Inj ogivri 10 mg Injection
ADD-Q5115-Inj truxima 10 mg
ADD-Q5116-Inj., trazimera, 10 mg
ADD-Q5117-Inj., kanjinti, 10 mg
ADD-Q5118-Inj., zirabev, 10 mg

Major Category I.F ambulatory surgery inclusions retroactive to January 1, 2015.
REMOVE-29580 - paste/unna boot
REMOVE-29581-29584 - application of multi compression systems

Major Category V Part B Therapy Inclusions retroactive to January 1, 2015:
ADD-29580 - paste/unna boot
ADD-29581 - Lower Extremity Application of Strapping

Page Last Modified:
12/09/2019 08:35 PM