Replacement Codes Updated on ERS Specialty Drug List

March 21, 2019

Blue Cross and Blue Shield of Texas (BCBSTX) has updated the Employees Retirement System of Texas (ERS) Specialty Drug Prior Authorization List for the following drugs codes to reflect their new replacement Healthcare Common Procedure Coding System (HCPCS) codes assigned by The Centers for Medicare & Medicaid Services (CMS):

  • Cuvitru — changed from J3590 to J1555
  • Exondys 51 — changed from J3590 & C9484 to J1428
  • Rituxan — changed from J9310 to J9312
  • Tecentriq Changed from C9483 to J9022

The ERS Specialty Drug Prior Authorization List can be found on the provider website under Preauthorizations/Notifications/Referral Requirements. These codes continue to require prior authorization for ERS participants.

If you have any questions, please contact your Network Management Representative.