Effective with the date of service Jan. 1, 2022, the Centers for Medicare and Medicaid Services (CMS) has added new HCPCS codes (J codes), deleted others and changed the description of some existing codes.
NC Medicaid and GDIT have completed system updates to align our policies with HCPCS code (J code) changes (new codes, covered and non-covered, as well as the 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 Dec. 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 1/1/2022) |
Description |
Brand Name |
NDC |
Price per Unit |
Old HCPCS code (Ineffective 12/31/2021) |
|
J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
Neulasta |
55513-0190-01 55513-0192-01 |
$183.74 |
J2505 |
|
J9021 |
Injection, asparaginase, recombinant, |
Rylaze |
68727-0900-01 |
$47.41 |
J3590 |
|
J9061 |
Injection, amivantamab-vmjw, 2 mg |
Rybrevant |
57894-0501-00 |
$17.91 |
J9999 |
|
J9272 |
Injection, dostarlimab-gxly, 10 mg |
Jemperli |
00173-0898-03 |
$215.12 |
J9999 |
Contact
NCTracks Call Center: 800-688-6696