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Correction to “Clinician Administered Drug – Injection – Lumasiran” in 2025–2026 ICD-10 Special Bulletin

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The “Clinician Administered Drug – Injection – Lumasiran” section of the 2025–2026 International Classification of Diseases, Tenth Edition (ICD-10) Special Bulletin was incorrect.

The correct content is as follows:

Clinician Administered Drug – Injection – Lumasiran (Oxlumo)

Lumasiran (Oxlumo) is indicated to treat primary hyperoxaluria type 1 (PH1) to lower urinary oxalate levels in pediatric and adult patients.

Claims for lumasiran (Oxlumo) (procedure code J0224) may be reimbursed when they are submitted with diagnosis code E72530.

For more information, call the TMHP Contact Center at 800-925-9126.

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.