HCPCS Code Section: HCPCS J Codes

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, …

Injection, brompheniramine maleate, per 10 mg Short Description: Brompheniramine maleate inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, dihydroergotamine mesylate, per 1 mg Short Description: Inj dihydroergotamine mesylt Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, testosterone enanthate and estradiol valerate, up to 1 cc Short Description: Testosterone enanthate inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, dexamethasone sodium phosphate, 1 mg Short Description: Dexamethasone sodium phos Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml Short Description: Phenylep ketorolac opth soln Coverage Code: Carrier judgment Action Code: Add procedure or modifier code …

Dexamethasone, lacrimal ophthalmic insert, 0.1 mg Short Description: Dexametha opth insert 0.1 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: October 1, 2019 …

Injection, dexamethasone 9 percent, intraocular, 1 microgram Short Description: Injection, dexamethasone 9% Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, dexamethasone acetate, 1 mg Short Description: Inj dexamethasone acetate Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2003 Effective …