CMS October 2026 MPFSDB CR 14588: 10 J-codes not valid for Medicare October 1

CMS issued Change Request 14588 on August 27, 2026, as Transmittal 13929 (Pub 100-04 Medicare Claims Processing). The subject line is the quarterly update to the Medicare Physician Fee Schedule Database (MPFSDB) for October 2026.

EFFECTIVE DATE: January 1, 2026 (date of service unless otherwise specified). IMPLEMENTATION DATE: October 5, 2026. The CR amends payment files that CMS already issued from the 2026 MPFS Final Rule, for services furnished between January 1, 2026, and December 31, 2026. Most attachment rows still print a record effective date of 20261001.

This is the physician fee schedule database, not the live October 2026 NCD ICD-10 coding CR, and not the live Alpha-Numeric HCPCS file / G0685 story. G0685 does appear on this attachment as status C. That is a pricing-status fact, not a second HCPCS-file release.

What CR 14588 updates

The transmittal says the purpose is to amend payment files issued to contractors based upon the 2026 MPFS Final Rule. It applies to Pub. 100-04, Medicare Claims Processing Manual, chapter 23, section 30.1. Policy authority printed in the CR is section 1848(c)(4) of the Social Security Act.

Business requirement 14588.1 says CMS will email Medicare contractors when the revised payment data are ready to retrieve from the cloud service. The note says those data will be available on or around August 21, 2026, and points to the attachment for the summary of changes and effective dates.

The attachment is 112 rows. Counted from the PDF: 97 new-code rows, 10 deleted-code rows, and 5 revised-descriptor rows (one of those, 0896T, is "revised short descriptor and global"). Unique HCPCS values are 110, because 1079T also has modifier 26 and TC rows. Status indicators on those 112 rows: C 66, E 25, I 10, A 6, X 5.

Where this CR prints only a short descriptor, this page does not invent a long one. Look up official titles in the encoder or the code book.

Deleted J-codes are status I on October 1

All 10 deleted rows are status I and print record effective date 20261001. CMS's MPFSDB status list (Medicare Claims Processing Manual, Chapter 23) defines I as not valid for Medicare purposes. Medicare uses another code for reporting of, and payment for, these services. The code is not subject to a 90-day grace period.

The CR does not print a crosswalk. The same attachment also adds new J- and Q-codes at status E (excluded from the physician fee schedule by regulation; no fee-schedule payment amounts; payment, when covered, continues under reasonable charge procedures). Treat the table as the CR's own list, not as a CMS "this replaces that" instruction.

Other new status E rows on the same attachment (short descriptors as printed) include J0871, J1757, J1818, J3268, J3406, J7531, J9066, Q5172, and Q5173. J9033 is a revised short descriptor at status E ("Inj, bendamustine (nos) 1mg"). Part B drug files belong next to the drugs desk, not in a guessed long title.

Status A rows print PE RVU 3.81

Six new rows are status A (active code; Medicare pays separately under the PFS if covered; an A indicator is not a national coverage determination). Each prints work RVU 0.00, non-facility PE RVU 3.81, facility PE RVU 3.81, MP RVU 0.00, glob ZZZ, and record effective date 20261001:

• A2046 Dermisphere hdrt, per sq cm
• A2047 Lacertamatrix, per sq cm
• A2049 Theracor, per sq cm
• Q4207 Carbon life, per sq cm
• Q4223 Dermabind sl optic per sq cm
• Q4243 Amchomatrix, per sq cm

Two neighboring new rows are status C with PE RVU 0.00: A2048 Puraply mz, per mg, and A2050 Fibrillar collagen, per mg. Status C means A/B MACs (B) price the code, generally case by case after documentation review.

Chapter 23 defines glob ZZZ as a code related to another service that Medicare always includes in the global period of the other service. This CR does not assign those six A-status products a national coverage decision.

Contractor-priced Category III codes and G0685

The attachment adds Category III CPT codes 1054T through 1111T (58 unique codes, no gaps in that range), all status C, work RVU 0.00. 1079T also has 26 and TC rows, both status C. Revised rows 0894T, 0895T, and 0896T are also status C. 0896T is the row labeled "revised short descriptor and global."

G0685 is a new-code row, status C, short descriptor "Algorithm assessment for asd", work RVU 0.00, glob XXX, physician-supervision-of-diagnostic-procedures value 04, record effective 20261001. Glob XXX means the global concept does not apply. This MPFSDB row is how the code sits on the physician fee schedule database. The live October 2026 HCPCS file / G0685 piece is the Alpha-Numeric HCPCS ZIP, not this CR.

One lab-looking row is not an October 1 record: 87638, new code, status X, short descriptor "Iadna dna/rna rubeola measls", record effective 20260515. Status X is statutory exclusion (examples on the Chapter 23 list include clinical diagnostic laboratory services). A9595 is a revised short descriptor at status X. New status X rows also include A9613, A4228, and A6614.

MAC search rule and the 30-day notice

Business requirement 14588.2 says Medicare contractors shall not search their files to retract payment for claims already paid or to retroactively pay claims. They shall adjust claims brought to their attention.

Business requirement 14588.3 says contractors shall, in accordance with Pub 100-04, chapter 23, section 30.1, give providers a 30-day notice before implementing the changes identified in this CR. Systems implementation for the transmittal is October 5, 2026.

If a claim needs one of these MPFSDB rows, bring that claim to the MAC. Do not wait for a paid-claims sweep.

BR 14588.4 tells CMS to notify the Common Working File maintainer when MPFSDB files are available, with file names for duplicate radiology editing, duplicate diagnostic editing, pathology editing, and RVU and payment indicator files.

What this is not

It is not a CMS-HCC or V28 mapping change. An MPFSDB status row is not a RAF map. If the question is risk adjustment, use the model year you are actually coding in ICD-10 to HCC.

It is not the live NCD ICD-10 coding revisions (CR 14464). Different publication, different attachment.

It is not the October 2026 CLFS and CLIA update (CR 14569). 87638 appears here as MPFSDB status X with record date 20260515. This page does not move that code onto the clinical lab fee schedule.

It is not a new Alpha-Numeric HCPCS ZIP. G0685 on this file is the MPFSDB status C row.

Look up official long descriptors in the encoder or the code book before you release a claim that depends on one of these lines.