Texas MedicaidMedium ImpactBilling Codes
Correction to Diagnosis Code for Darbepoetin Alfa in the Outpatient Drug Services Handbook
Published February 3, 2026
AI Summary
Texas Medicaid corrected a diagnosis code error for Darbepoetin Alfa in the Outpatient Drug Services Handbook. The incorrect diagnosis code D462 has been changed to the correct code D4621, effective with the February TMPPM release.
Action Required
Immediately: Billing team must update billing software and encounter forms to use diagnosis code D4621 instead of D462 for Darbepoetin Alfa claims. Verify any pending or recent claims used the correct code D4621. Contact TMHP at 800-925-9126 for questions. Claims with incorrect code D462 may be denied.
Affected Billing Codes
D462D4621
Plan Types
Medicaid
States
TX
Specialties
oncology, hematology, nephrology