HCPCS Code Section: HCPCS J Codes

Injection, ravulizumab-cwvz, 10 mg Short Description: Inj., ravulizumab-cwvz 10 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: October 1, 2019 Effective Date: October …

Injection, dyphylline, up to 500 mg Short Description: Dyphylline injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 Effective …

Injection, edaravone, 1 mg Short Description: Injection, edaravone, 1 mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January …

Injection, hydromorphone, up to 4 mg Short Description: Hydromorphone injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 Effective …

Injection, eculizumab, 10 mg Short Description: Eculizumab injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2008 Effective Date: January 1, 2008 …

Injection, phenytoin sodium, per 50 mg Short Description: Phenytoin sodium injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, ecallantide, 1 mg Short Description: Ecallantide injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2011 Effective Date: January 1, 2011 …

Injection, digoxin immune fab (ovine), per vial Short Description: Digoxin immune fab (ovine) Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Injection, doxercalciferol, 1 mcg Short Description: Injection, doxercalciferol Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2002 Effective Date: January 1, 2002 …

Injection, doripenem, 10 mg Short Description: Doripenem injection Coverage Code: Carrier judgment Action Code: Payment change (mog, pricing indicator codes, anesthesia base units) Date Added: January 1, 2009 Effective …