HCPCS replacement codes established

J1427 replaces J3490, J3590 and C9071 when billing for Viltepso (viltolarsen)

The Centers for Medicare & Medicaid Services has established a permanent procedure code for specialty medical drug Viltepso (viltolarsen).

All services through March 31, 2021, will continue to be reported with code J3490, J3590 and C9071. All services performed on and after April 1, 2021, must be reported with J1427.

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.

J1554 replaces J1599 and C9072 when billing for Asceniv (immune globulin intravenous, human ‑ slra)

CMS has established a permanent procedure code for specialty medical drug Asceniv (immune globulin intravenous, human ‑ slra).

All services through March 31, 2021, will continue to be reported with code J1599 and C9072. All services performed on and after April 1, 2021, must be reported with J1554.

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.

Site of care prior authorization is required through the Medical Benefit Drug Program for J1554 for all groups unless they are opted out of the program.

J9037 replaces J9999 and C9069 when billing for BLENREP (belantamab mafodontin‑blmf)

CMS has established a permanent procedure code for specialty medical drug BLENREP (belantamab mafodontin‑blmf).

All services through March 31, 2021, will continue to be reported with code J9999 and C9069. All services performed on and after April 1, 2021, must be reported with J9037.

AIM Specialty Health^® prior authorization is required for all groups unless they are opted out of the prior authorization program.

For groups that aren’t in the AIM prior authorization program, this code is covered for the FDA‑approved indications.

J9349 replaces J3590 and C9070 when billing for Monjuvi tafasitamab‑cxix.

CMS has established a permanent procedure code for specialty medical drug Monjuvi (tafasitamab‑cxix).

All services through March 31, 2021, will continue to be reported with code J3590 and C9070. All services performed on and after April 1, 2021, must be reported with J9349.

AIM Specialty Health^® prior authorization is required for all groups unless they are opted out of the prior authorization program.

For groups that aren’t in the AIM prior authorization program, this code is covered for the FDA‑approved indications.

J7402 replaces C9122 when billing for Sinuva (mometasone furoate) sinus implant

CMS has established a permanent procedure code for specialty medical drug Sinuva (mometasone furoate) sinus implant.

All services through March 31, 2021, will continue to be reported with code C9122. All services performed on and after April 1, 2021, must be reported with J7402.

Q2053 replaces J3590, J9999 and C9073 when billing for brexucabtagene autoleucel

CMS has established a permanent procedure code for specialty medical drug brexucabtagene autoleucel.

All services through March 31, 2021, will continue to be reported with code J3590, J9999 and C9073. All services performed on and after April 1, 2021, must be reported with Q2053.

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.