Medicare AdvantageBilling CodesHigh impact
22-662 Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 3rd Quarter 2022
Health Net·CA · Oncology, Endocrinology, Ophthalmology +3 more·Pharmacy
Effective date
Oct 31, 2022
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk with 10 new injectable medications, 20 procedure code updates/changes, and 2 DOFR category updates. This affects billing for injectable medications, with many drugs receiving new specific HCPCS codes to replace generic codes like J3490 and J3590.
Action Required
By October 31, 2022: Billing team must update billing system with new HCPCS codes for injectable medications. Replace generic codes (J3490, J3590) with specific codes for drugs like Mounjaro (J3590), Leqvio (J1306), and others listed. Delete obsolete cyclophosphamide codes J9080-J9092. Update encounter forms and drug databases. Verify secondary categories for chemotherapy and HIV/AIDS medications match ICD-10 diagnosis codes. Claims using old codes after effective date may be denied.