HCPCS Code Section: HCPCS J Codes

Injection, voriconazole, 10 mg Short Description: Injection, voriconazole Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2004 Effective Date: January …

Injection, phytonadione (vitamin k), per 1 mg Short Description: Vitamin k phytonadione inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Laetrile, amygdalin, vitamin b17 Short Description: Laetrile amygdalin vit b17 Coverage Code: Non-covered by Medicare Action Code: No maintenance for this code Date Added: January 1, 1986 Effective Date: …

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg Short Description: Vitamin b12 injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Drug administered through a metered dose inhaler Short Description: Metered dose inhaler drug Coverage Code: Non-covered by Medicare Action Code: No maintenance for this code Date Added: January 1, …

Injection, pyridoxine hcl, 100 mg Short Description: Pyridoxine hcl 100 mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2004 Effective Date: …

Nasal vaccine inhalation Short Description: Nasal vaccine inhalation Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1986 Effective Date: January …

Injection, thiamine hcl, 100 mg Short Description: Thiamine hcl 100 mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2004 Effective Date: …

Edetate disodium, per 150 mg Short Description: Edetate disodium per 150 mg Coverage Code: Non-covered by Medicare Action Code: No maintenance for this code Date Added: January 1, 1986 …

Injection, hydroxyzine hcl, up to 25 mg Short Description: Hydroxyzine hcl injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …