HCPCS Code Section: HCPCS C Codes

Injection, elosulfase alfa, 1mg Short Description: Injection, elosulfase alfa Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: July 1, 2014 Effective Date: …

Injection, obinutuzumab, 10 mg Short Description: Injection, obinutuzumab Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: April 1, 2014 Effective Date: January …

Injection, triptorelin extended release, 3.75 mg Short Description: Inj, triptorelin ext rel Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, c-1 esterase inhibitor (human), haegarda, 10 units Short Description: C-1 esterase, haegarda Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Injection, cerliponase alfa, 1 mg Short Description: Injection, cerliponase alfa Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2018 Effective …

Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump Short Description: Prolonged iv inf, req pump Coverage Code: Special …

Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for …

Magnetic resonance angiography without contrast followed by with contrast, upper extremity Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: October 1, 2010 …

Magnetic resonance angiography without contrast, upper extremity Short Description: Mra, w/o dye, upper extr Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Magnetic resonance angiography with contrast, upper extremity Short Description: Mra, w/dye, upper extremity Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: October …