HCPCS Code Section: HCPCS J Codes

Injection, etelcalcetide, 0.1 mg Short Description: Inj, etelcalcetide, 0.1 mg Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2018 Effective …

Injection, ceftriaxone sodium, per 250 mg Short Description: Ceftriaxone sodium injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1990 …

Cinacalcet, oral, 1 mg, (for esrd on dialysis) Short Description: Cinacalcet, esrd on dialysis Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Injection, ceftolozane 50 mg and tazobactam 25 mg Short Description: Inj ceftolozane tazobactam Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2016 …

Injection, cefoxitin sodium, 1 gm Short Description: Cefoxitin sodium injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1992 Effective …

Injection, cefepime hydrochloride, 500 mg Short Description: Cefepime hcl for injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2002 Effective Date: …

Injection, cefazolin sodium, 500 mg Short Description: Cefazolin sodium injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 Effective …

Injection, mepivacaine hydrochloride, per 10 ml Short Description: Inj mepivacaine hcl/10 ml Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, levoleucovorin (khapzory), 0.5 mg Short Description: Injection, khapzory, 0.5 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: October 1, 2019 Effective Date: …

Injection, levoleucovorin, not otherwise specified, 0.5 mg Short Description: Inj levoleucovorin nos 0.5mg Coverage Code: Special coverage instructions apply Action Code: Change in long description of procedure or modifier …