HCPCS Code Section: HCPCS C Codes

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

Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u. Short Description: Factor viii pegylated-aucl Coverage Code: Special coverage instructions apply Action Code: Discontinue procedure or modifier code Date …

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

Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u. Short Description: Afstyla factor viii recomb Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, tagraxofusp-erzs, 10 mcg Short Description: Injection, tagraxofusp-erzs Coverage Code: Special coverage instructions apply Action Code: Discontinue procedure or modifier code Date Added: July 1, 2019 Effective Date: October …

Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u. Short Description: Idelvion, 1 i.u. Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Dexamethasone, lacrimal ophthalmic insert, 0.1 mg Short Description: Dexamethasone ophth insert Coverage Code: Special coverage instructions apply Action Code: Discontinue procedure or modifier code Date Added: July 1, 2019 …

Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u. Short Description: Nuwiq factor viii recomb Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u. Short Description: Adynovate factor viii recom Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, factor viii, fc fusion protein, (recombinant), per i.u. Short Description: Factor viii (eloctate) Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …