Interferon Beta 1A

Can the HCPC codes J1826 and Q3025 be used interchangeably? J1826 is a new code this year not recognized by Medicare.

Interferon

Coverage is for the treatment of several types of neoplasms and a limited number of other conditions. This coverage extends to secondary sites as well. Interferon may be given as frequently as daily, and for this reason, are often self-administered by the patient. Except for a few specifically defined drugs, not including interferon, Medicare does not cover self-administered drugs.

This A/B MAC will consider the administration of Q3025 (Interferon Beta-1a) for intramuscular use medically reasonable and necessary for the single indication of multiple sclerosis. CMS has previously ruled that Interferon Beta-1a is not considered self-administered. This A/B MAC will allow payment for Interferon Beta-1a when given by the provider, when given intramuscularly, and when it is medically reasonable and necessary for the patient's condition. Note: Q3026 (Interferon Beta-1a) for subcutaneous use is an "I" status (invalid) code and is therefore not covered by Medicare.