MedicaidBilling CodesHigh impact
20-893 Updates to the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 4th Quarter 2020
Health Net·CA · Oncology, Hematology, Endocrinology +4 more·Prior Authorization
Effective date
Jan 21, 2021
We identified it
Jun 20, 2026
Summary
Health Net updated their injectable medication HCPCS/DOFR crosswalk reference table with 12 new injectable medications and 26 code updates/changes. The billing team must update their systems to reflect new HCPCS codes for recently approved medications and remove discontinued medications from their billing options.
Action Required
By January 21, 2021: Billing team must update billing system with 12 new injectable medication HCPCS codes (including C9399 for Blenrep, J9145 for Darzalex, J0517 for Fasenra pen, etc.) and remove 15 discontinued medications from billing options (including Bayhep b, Bayrho-d, Baytet, Delatestryl variations). Update encounter forms and drug lists to reflect these changes. Verify DOFR categories for therapeutic injections vs self-injections to ensure proper billing.