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February 2017

J7202 replaces J7199 when billing for Idelvion® factor IX recombinant

The Centers for Medicare & Medicaid Services has established a permanent procedure code for Idelvion® factor IX recombinant (albumin fusion protein), effective Jan. 1, 2017.

All services from March 16, 2016, through Dec. 31, 2016, will continue to be reported with code J7199. All services performed on and after Jan. 1, 2017, must be reported with J7202.

Idelvion factor IX recombinant (albumin fusion protein) continues to be covered for the FDA-approved indication as establisted on March 16, 2016.

Pharmacy doesn’t require preauthorization of this drug.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
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