HCPCS Code Section: HCPCS C Codes

Factor ix (antihemophilic factor, recombinant), alprolix, per i.u. Short Description: Factor ix (alprolix) Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: October …

Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u. Short Description: Factor xiii a-subunit recomb Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Factor ix (antihemophilic factor, recombinant), rixubis, per i.u. Short Description: Factor ix recombinant Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity Short Description: Kcentra, per i.u. Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code …

Injection, argatroban, per 5 mg Short Description: Injection, argatroban Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2003 Effective Date: …

Injection, pantoprazole sodium, per vial Short Description: Inj pantoprazole sodium, via Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2002 …

Injection, brexanolone, 1mg Short Description: Inj, brexanolone Coverage Code: Special coverage instructions apply Action Code: Add procedure or modifier code Date Added: January 1, 2020 Effective Date: January 1, …

Injection, lefamulin (xenleta), 1 mg Short Description: Injection, lefamulin Coverage Code: Special coverage instructions apply Action Code: Add procedure or modifier code Date Added: January 1, 2020 Effective Date: …

Injection, ravulizumab-cwvz, 10 mg Short Description: Injection, ravulizumab-cwv Coverage Code: Special coverage instructions apply Action Code: Discontinue procedure or modifier code Date Added: July 1, 2019 Effective Date: October …

Injection, clevidipine butyrate, 1 mg Short Description: Inj, clevidipine butyrate Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2009 Effective …