MedicaidBilling CodesMedium impact
Hospital Monthly Important Message Updated as of 02/14/2018 pdf
Connecticut Medicaid (HUSKY Health)·CT · Oncology, Neurology·Provider Bulletin
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) updated multiple billing components effective January 1, 2018, including new drug codes for Eteplirsen and Nusinersen, increased outlier thresholds, and resolved duplicate claim processing issues. The policy also establishes new prior authorization requirements for CAR-T cell therapy.
Action Required
Immediately: Update billing system to use new codes J1428 for Eteplirsen (replacing C9484) and J2326 for Nusinersen (replacing C9489) for dates of service January 1, 2018 forward. Obtain prior authorization for procedure code Q2040 (Tisagenlecleucel CAR-T therapy). Re-submit any previously denied claims for these services. Monitor for claims reprocessing cycle on February 23, 2018 for status indicator G or K procedures.