Effective with the date of service July 1, 2022, the Center for Medicaid and Medicare Services has added new HCPCS codes (J codes) for drugs that were assigned to miscellaneous HCPCS codes.
NC Medicaid has completed system updates to align our policies with HCPCS 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 June 31, 2022. Previous policy restrictions set on the individual medication will continue onto the replacement HCPCS codes, unless otherwise noted.
|
New HCPCS (effective 7/1/2022) |
Description |
Brand Name (™) |
NDC |
Old HCPCS (Ineffective 6/30/2022) |
|
J9339 |
Injection, efgartigimod alfa-fcab, 2mg |
Vyvgart |
73475-3041-05 |
J3590 |
|
J0739 |
Injection, cabotegravir, 1 mg |
Apretude |
49702-0238-01 49702-0264-23 |
J3490 |
|
J1306 |
Injection, inclisiran, 1 mg |
Leqvio |
00078-1000-60 |
J3490 |
|
J3299 |
Injection, triamcinolone acetonide (xipere), 1 mg |
Xipere |
71565-0040-01 71565-0040-25 |
J3490 |
|
J2998 |
Injection, plasminogen, human-tvmh, 1 mg |
Ryplazim |
70573-0099-01 70573-0099-02 |
J3590 |
|
J2779 |
Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg |
Susvimo |
50242-0078-12 50242-0078-55 |
J3590 |
|
C9098 |
Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
Carvykti |
57894-0111-01 57894-0111-02 |
J9999 |
|
J9331 |
Injection, sirolimus protein-bound particles, 1 mg |
Fyarro |
80803-0153-50 |
J9999 |
Contact
NCTracks Call Center, 800-688-6696