Pharmacy Question for the Week of May 7, 2018

Pharmacy Compliance Question of the Week

Question:

Does CMS update the level II code set in the middle of the year as well as the start of the year? If so are there any new upcoming codes for drugs?

Answer:

The HCPCS code set is updated on a quarterly basis. On July 1, 2018, the following HCPCS codes will be established:

Q9991 Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
Q9992 Injection, buprenorphine extended-release (sublocade), greater than 100 mg
Q9993 Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
Q9995 Injection, emicizumab-kxwh, 0.5 mg

This information is available in transmittal 4025 (issued April 20, 2018) at https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018-Transmittals-Items/R4025CP.html.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.