CommercialBilling CodesMedium impact
20-381 New Updates to the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 2nd Quarter 2020
Health Net·CA · Oncology, Hematology, Endocrinology +3 more·Pharmacy
Effective date
Jul 9, 2020
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk Reference Table effective July 9, 2020, adding 8 new injectable medications with HCPCS codes, updating 8 existing procedure codes, and changing DOFR categories for 16 medications. This affects billing and coverage determination for injectable medications administered to Health Net members in specific California counties and Medi-Cal regions.
Action Required
By July 9, 2020: Billing team must update billing system with new HCPCS codes and revised DOFR categories for injectable medications. Replace obsolete codes (J9212, J9213 deleted; C9041 replaces J3590 for Andexxa; J1826 replaces Q3025 for Avonex; J0593 replaces J3590 for Takhzyro). Update encounter forms and charge capture systems to reflect new secondary categories for home health infusion and transplant drug classifications. Contact Health Net Provider Services within 60 days with any questions.