HCPCS Code Section: HCPCS J Codes

Injection, dmso, dimethyl sulfoxide, 50%, 50 ml Short Description: Dimethyl sulfoxide 50% 50 ml Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Injection, chlorothiazide sodium, per 500 mg Short Description: Chlorothiazide sodium inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 …

Injection, diphenhydramine hcl, up to 50 mg Short Description: Diphenhydramine hcl injectio Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, dexrazoxane hydrochloride, per 250 mg Short Description: Dexrazoxane hcl injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1997 …

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 …