HCPCS Code Section: HCPCS C Codes

Injection, granisetron extended release, 0.1 mg Short Description: Inj, granisetron ext Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: April 1, 2017 …

Injection, olaratumab, 10 mg Short Description: Injection, olaratumab Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: April 1, 2017 Effective Date: January …

Injection, eteplirsen, 10 mg Short Description: Injection, eteplirsen Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: April 1, 2017 Effective Date: January …

Injection, atezolizumab, 10 mg Short Description: Injection, atezolizumab Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: October 1, 2016 Effective Date: January …

Injection, sotalol hydrochloride, 1 mg Short Description: Sotalol hydrochloride iv Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: October 1, 2016 Effective …

Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure) …

Injection, reslizumab, 1 mg Short Description: Injection, reslizumab Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: October 1, 2016 Effective Date: January …

Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch Short Description: Perc drug-el cor stent sing Coverage Code: Special …

Injection, trabectedin, 0.1 mg Short Description: Injection, trabectedin Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: July 1, 2016 Effective Date: January …

Loxapine, inhalation powder, 10 mg Short Description: Loxapine, inhalation powder Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2014 Effective …