HCPCS Code Section: HCPCS J Codes

Injection, epoetin alfa, 1000 units (for esrd on dialysis) Short Description: Epoetin alfa 1000 units esrd Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code …

Injection, epoetin alfa, (for non-esrd use), 1000 units Short Description: Epoetin alfa, non-esrd Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

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

Injection, argatroban, 1 mg (for non-esrd use) Short Description: Argatroban nonesrd use 1mg Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) Short Description: Darbepoetin alfa, esrd use Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, darbepoetin alfa, 1 microgram (non-esrd use) Short Description: Darbepoetin alfa, non-esrd Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, daptomycin, 1 mg Short Description: Daptomycin injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2005 Effective Date: January 1, 2005 …

Injection, dalbavancin, 5 mg Short Description: Injection, dalbavancin Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2016 Effective Date: January 1, 2016 …

Injection, cytomegalovirus immune globulin intravenous (human), per vial Short Description: Cytomegalovirus imm iv /vial Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Injection, crotalidae immune f(ab’)2 (equine), 120 mg Short Description: Inj crotalidae im f(ab’)2 eq Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …