2 HCPCS replacement codes take effect July 1

The HCPCS procedure codes described below are effective July 1, 2019.

J7208 replaces J7199 when billing from JIVI^® (antihemophilic factor, recombinant [Pegylated-aucl]).

The Centers for Medicare & Medicaid Services has established a permanent procedure code for specialty medical drug JIVI (triamcinolone acetonide extended-release injectable suspension, for intra-articular use).

All services from Aug. 30, 2018, through June 30, 2019, can continue to be reported with J7199. All services performed on and after July 1, 2019, must be reported with J7208.

Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u. continues to be covered for FDA-approved indications, which is in the routine prophylactic treatment of hemophilia A in previously treated adults and adolescents age 12 or older.

Pharmacy doesn’t require preauthorization of this drug.

Q5114 replaces J9999 when billing Ogivri, trastuzumab-dkst, biosimilar.

CMS has an established a permanent procedure code for Ogivri.

All services from Dec. 1, 2017, through June 30, 2019, will continue to be reported with procedure code J9999. All services performed on and after July 1, 2019, must be reported with Q5114.

Ogivri continues to be covered for the approved FDA indications as established on Dec. 1, 2017.

Pharmacy doesn’t require preauthorization of this drug.

For more information about HCPCS codes, see the article titled HCPCS, CPT updates and early release codes.