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MedicaidBilling CodesMedium impact

21-358 Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 1st Quarter 2021

Health Net·CA · Oncology, Hematology, Infectious Disease +3 more·Pharmacy
Effective date
Jul 16, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk with 16 new injectable medications and 9 code changes for Participating Physician Groups. The updates include new drugs like Amondys 45, Breyanzi, and Cosela, plus code changes for existing medications like Asceniv and Bamlanivimab.

Action Required

Action needed
By July 16, 2021: Billing team must update billing software and encounter forms with 16 new injectable medication HCPCS codes and 9 code changes. Replace obsolete codes (C0239 with Q0239, J9399 with J1554 for Asceniv, C9122 with J7402 for Sinuva). Verify DOFR categories for proper billing of therapeutic injections, chemotherapy, and self-injection medications.

Affected Billing Codes

J3490
J9999
J2354
J9027
J3590
C9399
J0122
J1554
Q0239
J9037
J9349
J7401
J7402
C9073
J1823
J1427
J9399
C0239
C9122
J9358