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June 4, 2010

Medicare Codes for Facial Fillers Now Available

Healthcare Common Procedure Coding System (HCPCS) numbers have been assigned to two facial fillers for HIV-related lipoatrophy, which should make it easier for patients covered by Medicare to receive treatment. The new HCPCS codes were announced in an update from the Department of Health and Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) published May 21. 

HCPCS codes are assigned to every service a clinician may provide to a Medicare patient including medical, surgical and diagnostic services. The codes are used by Medicare and maintained by CMS to ensure uniformity. 

CMS announced March 23 that it will begin covering the cost of U.S. Food and Drug Administration (FDA)–approved facial wasting fillers—Sculptra (poly-L-lactic acid) and Radiesse (calcium hydroxylapatite)—for Medicare beneficiaries who are experiencing symptoms of depression related to the stigmatizing effects of lipoatrophy. Until recently, however, Medicare recipients with HIV-associated lipoatrophy have had difficulty accessing the facial fillers due to the fact that HCPCS codes had not yet been assigned to the treatments. 

The assigned HCPCS code for Radiesse injections is Q2026, according to CMS. The assigned HCPCS code for Sculptra injections is Q2027. These codes are effective for claims with dates of service on or after March 23, 2010.

Search: Radiesse, Sculptra, lipoatrophy, CMS, Medicare, HCPCS, reimbursement


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