Update for Blood Clotting Factor Add-on Payments - Revised

Related CR Release Date: November 24, 2023 Revised
Effective Date: October 1, 2022
Implementation Date: April 1, 2024
MLN Matters Number: MM13381
Related Change Request (CR) Number: CR 13381
Related CR Transmittal Number: R12380CP

Note: CMS deleted HCPCS codes J7191 and J7199 and added J7177, J7178, and J7214 to the list of J codes on page 2.

CR 13381 tells you about:

  • Additional diagnosis codes eligible for payment for blood clotting factors
  • Adjustment of certain claims with the added codes

Make sure your billing staff knows about these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)13381.

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