DrugS

Neulasta® (pegfilgrastim) Onpro® and Neulasta® have an updated Healthcare Common Procedure Coding System (HCPCS) Code and dose descriptor, effective January 1, 2022.

The UPDATED HCPCS CODE is J2506.  The UPDATED DOSE DESCRIPTOR is Injection, pegfilgrastim, excludes biosimilar, 0.5 mg.  This updated dose descriptor can be billed in multiple units to accommodate a variety of doses. Providers should note the new dose descriptor is now 0.5 mg. Per label, the dose for Neulasta® (pegfilgrastim) is 6 mg. Please accurately report service units when billing.

Key dates: For dates of service on and after January 1, 2022, providers must use the updated HCPCS Code J2506, and dose descriptor, and discontinue use of the HCPCS Code J2505, as it will no longer be accepted. Providers may only use J2505 for dates of service on or before December 31, 2021.

Information on the updated code and dose descriptor is summarized in the following attachments:

• Neulasta® (pegfilgrastim) Onpro® and Neulasta® J-Code Flashcard, which contains the effective date, coding, and support service information and Neulasta® (pegfilgrastim) Onpro® and Neulasta® Billing and Coding Guide, which will provide you with detailed coding, dosing and administration, and support service information.
• Hospital Outpatient Coding and Billing Information Sheet 
• Physician Office Coding and Billing Information Sheet
• Please see full Prescribing Information for Neulasta® (pegfilgrastim) Onpro® and Neulasta® by clicking the link below:  Neulasta® Prescribing Information

The CMS 2021 ASP Drug Pricing Files for the 4th quarter effective October 1, 2021 through December 31, 2021 reflects updates for ISTODAX® (romidepsin) for injection, for intravenous use.  The update includes the following changes which are effective October 1, 2021:

• Discontinued HCPCS Code J9315 “Injection, romidepsin, 1mg” on September 30, 2021 and established J9319 “Injection, romidepsin, lyophilized, 0.1mg” on October 1, 2021.
• Changed the HCPCS Code Dosage from 1mg to 0.1 mg.

Per CMS, this change in J-code needed to be made because: “A new HCPCS code for Romidepsin Injection, non-lyophilized liquid is needed because it is a single source drug approved under a unique NDC number, and it needs to be differentiated from the existing HCPCS code for a multi-sourced Romidepsin drug in lyophilized powder form."

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Effective July 1, 2020, the following code J9358 can be used to identify ENHERTU® (fam-trastuzumab deruxtecan-nxki) when billing across settings of care as noted in the CMS HCPCS Application Summaries and Coding Decisions.

Astellas announces the assignment of a product-specific, permanent J-code for PADCEV. The Centers for Medicare & Medicaid Services (CMS) released the July 2020 Quarterly Healthcare Common Procedural Coding System (HCPCS) File, which includes the designation of J9177 for PADCEV with the effective date of July 1, 2020.