Correction to the ERS Specialty Drug List for Makena and Inflectra

October 22, 2018

Blue Cross and Blue Shield of Texas (BCBSTX) discovered that the Healthcare Common Procedure Coding System (HCPCS) for the two codes listed below were replaced by the Centers for Medicare & Medicaid Services (CMS) in 2018.

  • Makena changed from J1725 to J1726
  • Inflectra changed from Q5102 to Q5103

The ERS Specialty Drug Prior Authorization List PDF Document has been updated with the replacement codes and posted to the Provider Website under Preauthorizations/Notifications/Referral Requirements. The names of the drugs are correctly listed on the ERS Specialty Drug Prior Authorization List and continue to require prior authorization.

We apologize for any inconvenience the delay in identifying the code changes may have caused. If you have any questions, please contact your Network Management Representative.