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.

Last Updated Dec 07 , 2023