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Try CasePilot| Short Descr | Inj mogamulizumab-kpkc | Related Drugs | POTELIGEO | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 53 – Statute | MPI | A – Not applicable, as HCPCS priced under one methodology | Statute | 1833(t) | BETOS | O1E – Other drugs | TOS Code(s) | 9 – Other medical items or services | Added Date | 1/1/2019 | Termination Date | 9/30/2019 | APC Status Indicator | Pass-Through Drugs and Biologicals | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
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| 2019-09-30 | Deleted | Code deleted, see J9204. |
| 2019-01-01 | Added | Added |
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