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MedicaidBilling CodesMedium impact

Coding Change for Hydroxypogesterone Caproate pdf

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN·Coding
Effective date
Jul 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Effective July 1, 2017, Connecticut Medicaid discontinued HCPCS code J1725 for hydroxyprogesterone caproate injections. Outpatient hospitals must now use codes Q9985 (generic) or Q9986 (brand name Makena) for these injections, with each code representing 10 mg units.

Action Required

Action needed
By July 1, 2017: Billing team must stop using J1725 for hydroxyprogesterone caproate injections and update billing system to use Q9985 (generic) or Q9986 (Makena brand) instead. Update encounter forms and charge masters. Monitor for updated Addendum B coverage guidelines on www.ctdssmap.com.

Affected Billing Codes

J1725
Q9985
Q9986