HCPCS Code Section: HCPCS J Codes

Injection, galsulfase, 1 mg Short Description: Galsulfase injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2007 Effective Date: January 1, 2007 …

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

Injection, foscarnet sodium, per 1000 mg Short Description: Foscarnet sodium injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1993 …

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg Short Description: Inj fosnetupitant, palonoset Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Injection, fosaprepitant, 1 mg Short Description: Fosaprepitant injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2009 Effective Date: January 1, 2009 …

Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg Short Description: Octagam injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Injection, fomivirsen sodium, intraocular, 1.65 mg Short Description: Intraocular fomivirsen na Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2001 …

Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg Short Description: Immune globulin, powder Coverage Code: Special coverage instructions apply Action Code: No maintenance for this …

Injection, fomepizole, 15 mg Short Description: Fomepizole, 15 mg Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2006 Effective Date: …

Injection, immune globulin (vivaglobin), 100 mg Short Description: Vivaglobin, inj Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2007 Effective Date: January …