MedicaidBilling CodesHigh impact
Epogen Billing Changes for Renal Dialysis Claims
Illinois Medicaid - HFS·IL · Nephrology·Provider Notice
Effective date
Jan 1, 2007
We identified it
Jun 21, 2026
Summary
New HCPCS code Q4081 is required for all Epogen (Epoetin Alfa) billing on renal dialysis claims starting January 1, 2007. Claims missing this code with revenue codes 634 or 635 will be rejected with error code H11.
Action Required
By January 1, 2007: Billing team must update system to require HCPCS code Q4081 with every revenue code 634 and 635 on outpatient renal dialysis claims (category of service 25). Continue reporting Value Code 68 with unit quantities. Update billing software to prevent submission without Q4081 as claims will be rejected with error code H11.