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HCPCS Level II Drug Codes Updated July 1

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  • May 13, 2011
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The July 1 quarterly HCPCS Level II update includes a handful of important drug/biological code changes.
Effective July 1, HCPCS Level II code J7184 will be directly replaced with Q2041 Injection, Von Willebrand factor complex (human), Wilate, per 100 IU VWF RCo, which describes Wilate® for intravenous injection for spontaneous or trauma-induced bleeding in patients with von Willebrand Disease (VWD), a hereditary bleeding disorder.
Also effective for dates of service on or after July 1 are three new Q codes payable for Medicare:

  • Q2042 Injection, hydroxyprogesterone caproate, 1 mg

Hydroxyprogesterone caproate is a synthetic steroid hormone. The U.S. Food and Drug Administration (FDA) approved the drug, marketed as Makena™ on Feb. 3, 2011 for prevention of preterm delivery in women with a history of preterm delivery.

  • Q2043 Sipuleucel-T, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion

Sipuleucel-T (Provenge®) is a therapeutic cancer vaccine, approved by the FDA in April 2010 for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer.

  • Q2044 Injection, belimumab, 10 mg

Marketed as Benlysta®, belimumab was FDA-approved for treatment of systemic lupus erthmatosis (SLE) on March 9, 2011 and is investigational for other autoimmune diseases.
For details on code implementation, see the Centers for Medicare & Medicaid Services’ (CMS’) Transmittal 2207.

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