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21-356 Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 1st Quarter 2021

Health Net·CA · Oncology, Hematology, Infectious Disease +4 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 Reference Table with 16 new injectable medications and 9 code changes/updates. This affects billing for injectable medications with specific DOFR category assignments and includes new HCPCS codes that must be used for proper reimbursement.

Action Required

Action needed
By July 16, 2021: Billing team must update billing software with 16 new injectable medication HCPCS codes and 9 code changes. Update encounter forms and coding references to reflect new DOFR categories for therapeutic injections, chemotherapy drugs, and self-injections. Ensure proper code assignment based on primary and secondary categories to avoid claim denials.

Affected Billing Codes

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