MedicaidBilling CodesMedium impact
Coding Changes for Eteplirsen and Nusinersen pdf
Connecticut Medicaid (HUSKY Health)·CT · Neurology, Pediatrics·Coding
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Effective January 1, 2018, billing codes for two medications changed: Eteplirsen (Exondys 51) switched from C9484 to J1428, and Nusinersen (Spinraza) switched from C9489 to J2326. Claims with new codes will initially deny until the system is updated, then will be automatically reprocessed.
Action Required
Effective January 1, 2018: Replace code C9484 with J1428 for Eteplirsen injections (10mg) and replace code C9489 with J2326 for Nusinersen injections (0.1mg) in billing system. Billing team should either hold claims until system update is announced or submit with new codes knowing they will initially deny and be automatically reprocessed later.