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October 2023

HCPCS replacement codes, effective July 6, 2023, established

J0174 replaces C9399 J3490, J3590 and J9999 when billing for Leqembi (lecanemab-irmb)

Effective July 6, 2023, the Centers for Medicare & Medicaid Services established a permanent procedure code for the specialty medical drug Leqembi (lecanemab-irmb).

Report all services through July 5, 2023, with J3490, J3590, C9399 and J9999. All services performed on and after July 6, 2023, must be reported with J0174.

None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with all applicable state and federal laws and regulations.

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 2022 American Medical Association. All rights reserved.