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MedicaidBilling CodesMedium impact

21-797 Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 4th Quarter 2021

Health Net·CA · Oncology, Endocrinology, Neurology +4 more·Pharmacy
Effective date
Jan 28, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk with 15 new injectable medications and 35 code updates/changes. This affects billing for injectable medications including new drugs like Aduhelm, Empaveli, and Wegovy, plus removal of many inactive flu vaccine codes.

Action Required

Action needed
By January 28, 2022: Billing team must update billing system with new HCPCS codes for 15 new injectable medications (including Aduhelm C9399/J3590, Empaveli C9399/J3490, Wegovy J3490) and remove 35 inactive codes (primarily flu vaccine codes). Update encounter forms to reflect new drug codes and DOFR categories. Contact Health Net Provider Services within 60 days with questions.

Affected Billing Codes

C9399
J3590
J3490
J9318
J9319
90662
90686
90687
90688
J2182
90656
Q2035
A9590
Q0239
Q2054
J0741
J1448
J9100
J9110
J1305
J0699
J0693
90653
90673
Q2036
90672
Q2037
90658
90630
Q2038
Q2039
90655
J7326
J9247