Effective with the date of service April 1, 2021, the Centers for Medicare & Medicaid Services (CMS) added new HCPCS codes (J codes), deleted others and changed the description of some existing codes. For complete information regarding all HCPCS codes and descriptions, refer to the 2021 edition of HCPSC Level II, published by Optum.
NC Medicaid and GDIT completed system updates to align our policies with HCPCS code (J code) changes (new codes, covered and non-covered, as well as end-dated codes) to ensure claims billed with the new codes will process and pay correctly.
Claims submitted with deleted codes will be denied for dates of service on or after March 31, 2021. Previous policy restrictions continue in effect unless otherwise noted. This includes restrictions, which may be on a deleted code that are continued with the replacement code(s).
|
New HCPCS code (effective 4/1/2021) |
Description |
Brand Name |
NDC |
Price per Unit |
Old HCPCS code (Ineffective 03/31/2021) |
|
J1554 |
Injection, immune globulin, 500 mg |
Asceniv |
69800-0250-01 69800-0250-02 |
$481.77 |
J1599 |
|
J7402 |
Mometasone furoate sinus implant, 10 micrograms |
Sinuva |
10599-0003-01 |
$10.25 |
J7401 |
|
J9037 |
Injection, belantamab mafodontin-blmf, 0.5 mg |
Blenrep |
00173-0896-01 |
$42.97 |
J9999 |
|
J9349 |
Injection, tafasitamab-cxix, 2 mg |
Monjuvi |
73535-0208-01 |
$12.66 |
J9999 |
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