HCPCS Code Section: HCPCS J Codes

Injection, levofloxacin, 250 mg Short Description: Levofloxacin injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1999 Effective Date: January …

Injection, levocarnitine, per 1 gm Short Description: Inj levocarnitine per 1 gm Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, levetiracetam, 10 mg Short Description: Levetiracetam injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2009 Effective Date: January 1, 2009 …

Injection, leuprolide acetate (for depot suspension), per 3.75 mg Short Description: Leuprolide acetate /3.75 mg Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, lepirudin, 50 mg Short Description: Lepirudin Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2006 Effective Date: January 1, …

Injection, meperidine hydrochloride, per 100 mg Short Description: Meperidine hydrochl /100 mg Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, aripiprazole lauroxil, (aristada), 1 mg Short Description: Aripirazole lauroxil 1 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: October 1, 2019 Effective …

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

Injection, aripiprazole lauroxil, (aristada initio), 1 mg Short Description: Inj., aristada initio, 1 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: October 1, …

Injection, mannitol, 25% in 50 ml Short Description: Mannitol injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1986 Effective …