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22-661 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
Days to comply

Summary

Health Net/CalViva Health updated their Injectable Medication HCPCS/DOFR Crosswalk for Q3 2022, adding 10 new injectable medications, updating 20 existing medication codes, and changing 2 DOFR categories. Many medications moved from temporary codes (J3490, J3590) to permanent specific codes.

Action Required

Action needed
By October 31, 2022: Billing team must update billing system with new specific HCPCS codes for injectable medications, replacing temporary codes J3490 and J3590 with permanent codes where specified. Update encounter forms and drug coding references. Delete obsolete cyclophosphamide codes (J9080, J9090, J9091, J9092, C9087). Verify DOFR category assignments for chemotherapy drugs requiring cancer diagnosis codes C00.0-C96.9.

Affected Billing Codes

J3590
J3490
Q0222
C9999
J0879
J9999
J9359
J0739
C9098
J9080
J9090
J9091
J9092
C9087
C9094
J9331
C9095
J1306
J0219
C9096
J2998
J0491
J2779
J2356
C9097
J9332
J3299
J0741
J3591