Medical Policy and Coding Updates - January 2020
This WA and Alaska medical policy and coding update lists changes with effective dates from November 30, 2019 through April 3, 2020. Coding updates list codes such as J2350, 55874, J3060, J9213 and hip arthroplasty codes 27130, 27132, 27134, 27137 and 27138 as now requiring review for medical necessity and prior authorization, and list cosmetic codes 15771 through 15774 as now requiring review and considered cosmetic. Special notices state that Trazimera (trastuzumab-qyyp) is a first-line biosimilar for HER2-positive breast cancer, and that Ruxience (rituximab-pvvr) is a first-line biosimilar for non-Hodgkin's lymphoma and chronic lymphocytic leukemia.