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Retroactive Updates for Leuprolide Acetate

April 28, 2016

Effective retroactively for dates of service on or after September 1, 2012, policy language and billing instructions are updated in the provider manual for Healthcare Common Procedure System (HCPCS) codes J1950 (injection, leuprolide acetate [for depot suspension], per 3.75 mg) and J9217 (leuprolide acetate [for depot suspension], 7.5 mg).

For claims denied with dates of service on or after September 1, 2012, providers may submit new claims for denials due to incorrect coding of HCPCS codes J1950 or J9217. Providers may also submit new claims for denials due to incorrect billing with J9217 in place of J1950 or vice versa. To initiate a new claim, providers must submit a Claims Inquiry Form (CIF) to void the previously denied claim. Both the CIF and new claim must be submitted together.