HCPCS replacement codes established

J1738 replaces J3490, J3590 and C9059 when billing for Anjeso (meloxicam)

The Centers for Medicare & Medicaid Services has established a permanent procedure code for Anjeso.

All services through Sept. 30, 2020, will continue to be reported with code J3490, J3590 or C9059. All services performed on and after Oct. 1, 2020, must be reported with J1738.

J3032 replaces J3490, J3590 and C9063 when billing for VYEPTI (eptinezumab-jjmr)

CMS has established a permanent procedure code for VYEPTI™.

All services through Sept. 30, 2020, will continue to be reported with code J3490, J3590 or C9063. All services performed on and after Oct. 1, 2020, must be reported with J3032.

Prior authorization is required for all groups unless they are opted out of the prior authorization program.

For groups that have opted out of the prior authorization program, this code is covered for the FDA-approved indications.

J3241 replaces J3490, J3590 and C9061 when billing for TEPEZZA (teprotumumab-trbw)

CMS has established a permanent procedure code for TEPEZZA™.

All services through Sept. 30, 2020, will continue to be reported with code J3490, J3590 or C9061. All services performed on and after Oct. 1, 2020, must be reported with J3241.

Prior authorization is required for all groups unless they are opted out of the prior authorization program.

For groups that have opted out of the prior authorization program, this code requires manual review for individual consideration.

J7351 replaces J3490 and J3590 when billing for DURYSTA (bimatoprost)

CMS has established a permanent procedure code for DURYSTA™.

All services through Sept. 30, 2020, will continue to be reported with code J3490, or J3590. All services performed on and after Oct. 1, 2020, must be reported with J7351.

J9227 replaces J3490 and J3590 when billing for SARCLISA (isatuximab-irfc)

CMS has established a permanent procedure code for SARCLISA^®.

All services through Sept. 30, 2020, will continue to be reported with code J3490 or J3590. All services performed on and after Oct. 1, 2020, must be reported with J9227.