Correction Coding Update – J3490

Effective 10/1/24 prior authorizations using dump code J3490 can no longer be used if the requested drug has an appropriate HCPCS code. Prior authorizations using J3490 will be rejected, using the appropriate HCPCS code will correct this issue.

Home Infusion Therapy Update

Compounded Sterile Preparation (CSP) means a preparation intended to be sterile that is created by combining, admixing, diluting, pooling, reconstituting, repackaging, or otherwise altering a drug product or bulk drug substance.

S9430 should be billed per dose of the compounded medication.

Reimbursement for S9430 includes all professional pharmacy services rendered in relation to providing the compounded medication to the patient.

HIT Billing Guideline »

Updated: The BCBSWY Provider Manual Prior Authorization section was updated to reflect current review timelines. Find the new version here.

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