HCPCS Code Section: HCPCS J Codes

Injection, pegloticase, 1 mg Short Description: Pegloticase injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2012 Effective Date: January 1, 2012 …

Injection, pegfilgrastim, 6 mg Short Description: Injection, pegfilgrastim 6mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2004 Effective Date: January 1, …

Injection, pegademase bovine, 25 iu Short Description: Pegademase bovine, 25 iu Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2006 …

Injection, prednisolone acetate, up to 1 ml Short Description: Prednisolone acetate inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, pegaptanib sodium, 0.3 mg Short Description: Pegaptanib sodium injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2006 Effective Date: January …

Injection, desmopressin acetate, per 1 mcg Short Description: Inj desmopressin acetate Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1996 …

Injection, pasireotide long acting, 1 mg Short Description: Inj, pasireotide long acting Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2016 Effective …

Injection, oxytocin, up to 10 units Short Description: Oxytocin injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1986 Effective …

Injection, paricalcitol, 1 mcg Short Description: Paricalcitol Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2003 Effective Date: January 1, …

Injection, plerixafor, 1 mg Short Description: Plerixafor injection Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2010 Effective Date: January 1, 2010 …