BCBSM/BCN Dual Header The Record Header Logo

The Record - Insurance Card with the BCBSM/BCN Cross and Shield logo that reads, Blue Cross Blue Shield, Blue Care Network of Michigan. Tagline: Confidence comes with every card. Image of Note boards with paper that has the letters RX on it accompanied by a stethoscope

Forward to a friend  |  Subscribe  |  The Record Archive  |  Contacts  |  bcbsm.com  |  Print this article
July 2018

Effective July 1, use new procedure code Q9995 for anti-hemophilia drug

The Center for Medicare & Medicaid Services has established a procedure code for emicizumab-kxwh, effective July 1, 2018.

When reporting injection services for this drug that were performed from Nov. 16, 2017, through June 30, 2018, continue to use code J7199. All injection services performed on or after July 1, 2018, must be reported with procedure code Q9995.

Emicizumab-kxwh continues to be covered for FDA-approved indications as established on Nov. 16, 2017. The U.S. Food and Drug Administration has approved this drug for use in preventing or reducing frequency of bleeding episodes in adults and pediatric patients who:

  • Have hemophilia A
  • Have developed antibodies called Factor VIII inhibitors via subcutaneous injection

This drug doesn’t require prior authorization from Blue Cross Blue Shield of Michigan.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.