Billing and Coding: Billing Limitations for Pharmacies - R4 - Effective January 1, 2021

This Local Coverage Determination (LCD) has been revised under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

LCA Medicare Coverage Database Number: A56119
Effective Date: January 1, 2021

Summary of Changes: The Billing and Coding Article has been updated with a CPT Code addition and descriptor change:

  • CPT codes added:
    • J7212 - FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT)-JNCW (SEVENFACT), 1 MICROGRAM
  • CPT Code Descriptors were changed for the following:
    • J7189
Old Description New Description
FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), PER 1 MICROGRAM FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM

 

Visit the Medicare Coverage Articles webpage to view the locally hosted Active LCA or access it via the CMS MCD.

 

            Last Updated Thu, 11 Feb 2021 19:19:42 +0000