Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Medi-Cal Logo
Click to Sign Up for MCSS emails

Correction: Treatment Restrictions and Billing Requirements Revised for Ipilimumab

August 9, 2019

A previous article that published in the June 2019 Medi-Cal Update titled “Treatment Restrictions and Billing Requirements Revised for Ipilimumab” erroneously listed J9928 as the HCPCS code for ipilimumab. The correct HCPCS code is J9228. The corrected article follows:

Effective for dates of service on or after July 1, 2019, the indications, age restriction, dosage, Treatment Authorization Request (TAR) and diagnosis code requirements for HCPCS code J9228 (injection, ipilimumab, 1 mg) have been revised. Ipilimumab is indicated for patients 12 years of age and older for the treatment of metastatic colorectal cancer, unresectable or metastatic melanoma and renal cell carcinoma and for the adjuvant treatment of cutaneous melanoma. The recommended dosage varies based on the treatment condition. An authorized TAR is required for reimbursement.