New HCPCS Code Changes From July 2019

The HCPCS code set is updated on a quarterly basis. CR 11296 informs MACs and providers ofthe updated specific drug/biological HCPCS codes. The April 5, 2019, HCPCS file includes 10new HCPCS codes. Beginning on July 1, 2019, these HCPCS codes will be established andmay be used in submitting claims under Medicare effective for claims with dates of service on orafter July 1, 2019,

1) J1444

a. Short Descriptor: Fe pyro cit pow 0.1 mg iron
b. Long Descriptor: Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron
c. Type of Service (TOS): 1, L

2) J7208
a. Short Descriptor: Inj. jivi 1 iu 
b. Long Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), pegylatedaucl, (jivi), 1 i.u.
c. TOS: 1

3) J7677
a. Short Descriptor: Revefenacin inh non-com 1mcg
b. Long Descriptor: Revefenacin inhalation solution, fda-approved final product, noncompounded, administered through DME, 1 microgram
c. TOS: 1, P

4) J9030
a. Short Descriptor: Bcg live intravesical 1mg
b. Long Descriptor: BCG live intravesical instillation, 1 mg
c. TOS: 1, P

5) J9036
a. Short Descriptor: Inj., belrapzo/bendamustine
b. Long Descriptor: Injection, bendamustine hydrochloride, (Belrapzo/bendamustine), 1mg
c. TOS: 1

6) J9356
a. Short Descriptor: Inj. herceptin hylecta, 10mg
b. Long Descriptor: Injection, trastuzumab, 10 mg and Hyaluronidase-oysk
c. TOS: 1

7) Q5112
a. Short Descriptor: Inj ontruzant 10 mg
b. Long Descriptor: Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mg
c. TOS: 1, P

8) Q5113
a. Short Descriptor: Inj herzuma 10 mg
b. Long Descriptor: Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mg
c. TOS: 1, P

9) Q5114
a. Short Descriptor: Inj ogivri 10 mg
b. Long Descriptor: Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mg
c. TOS: 1, P

10) Q5115
a. Short Descriptor: Inj truxima 10 mg
b. Long Descriptor: Injection, rituximab-abbs, biosimilar, (Truxima), 10 mg
c. TOS: 1, P

HCPCS code J9031 (Bcg (intravesical) per instillation) is being discontinued effective July 1,2019, and may not be used in submitting claims under Medicare effective for claims with datesof service on or after July 1, 2019.
The long and short descriptors for HCPCS code J9355 will be modified, effective for claims withdates of service on or after July 1, 2019, The TOS and all other indicators will remain the same. 

• J9355 Short Descriptor: Inj trastuzumab excl biosimi
• J9355 Long Descriptor: Injection, trastuzumab, excludes biosimilar, 10 mg

Source:Quarterly – HCPCS Code Changes – July 2019