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20-647 New Updates to the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 3rd Quarter 2020

Health Net·CA · Oncology, Hematology, Rheumatology +3 more·Prior Authorization
Effective date
Nov 3, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk Reference Table effective November 3, 2020, adding 12 new injectable medications with specific HCPCS codes, updating 18 existing medication procedure codes, and changing 1 DOFR category assignment. This affects billing and prior authorization requirements for injectable medications administered by participating physician groups.

Action Required

Action needed
Before November 3, 2020: Billing team must update billing software and encounter forms with 12 new injectable medication HCPCS codes (C9059, J3490, Q5121, A9590, J7204, A9513, J1201, C9399, J9999, J7333, J0691) and 18 updated codes with new descriptions. Update DOFR category assignments for proper division of financial responsibility. Access updated provider operations manuals in the Health Net Provider Library for complete crosswalk reference table. Contact Health Net Provider Services within 60 days with questions.

Affected Billing Codes

C9059
J3490
Q5121
A9590
J7204
A9513
J1201
C9399
J9999
J7333
J0691
J1815
J0791
J9245
J7169
J9246
J9358
J0223
J9198
J9177
J0742
J0896
Q5119
C9122
C9061
J1429
J1558
Q5120
J3399