CMS announces new Crohn's Disease code after AGA, ACG petition — 4 insights

CMS announced that HCPCS code Q9989 can describe Stelara for intravenous use starting July 1, 2017.

Here's what you should know.

1. The American Gastroenterological Association and American College of Gastroenterology petitioned CMS to implement an off-cycle code.

2. AGA recommends physicians confirm with individual payers that they will accept the code, before implementing it.

3. CMS currently denotes Stelara for IV use with unclassified codes HSPCS J3590 or C9399. The AGA said these unclassified codes are manually processed and "burdensome."

4. AGA expects CMS to announce a permanent HCPCS code for Stelara in summer 2017, going into effect Jan. 1, 2018.

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