HCPCS Code Section: HCPCS J Codes

Injection, testosterone cypionate, up to 100 mg Short Description: Testosterone cypionat 100 mg Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Injection, testosterone cypionate and estradiol cypionate, up to 1 ml Short Description: Testosterone cypionate 1 ml Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code …

Injection, medroxyprogesterone acetate, 1 mg Short Description: Medroxyprogesterone acetate Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2013 Effective Date: January 1, …

Injection, methylprednisolone acetate, 80 mg Short Description: Methylprednisolone 80 mg inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, methylprednisolone acetate, 40 mg Short Description: Methylprednisolone 40 mg inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, digoxin, up to 0.5 mg Short Description: Digoxin injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 Effective …

Injection, methylprednisolone acetate, 20 mg Short Description: Methylprednisolone 20 mg inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, diclofenac sodium, 0.5 mg Short Description: Inj diclofenac sodium 0.5mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2017 Effective Date: …

Injection, depo-estradiol cypionate, up to 5 mg Short Description: Depo-estradiol cypionate inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, acetazolamide sodium, up to 500 mg Short Description: Acetazolamid sodium injectio Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …