HCPCS Code Section: HCPCS J Codes

Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u. Short Description: Factor viii pegylated recomb Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) Short Description: Aminolevulinic acid hcl top Coverage Code: Carrier judgment Action Code: No maintenance for this …

Injection, factor viii fc fusion protein (recombinant), per iu Short Description: Factor viii fc fusion recomb Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code …

Etonogestrel (contraceptive) implant system, including implant and supplies Short Description: Etonogestrel implant system Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January …

Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu Short Description: Factor ix recomb gly rebinyn Coverage Code: Special coverage instructions apply Action Code: No maintenance for this …

Levonorgestrel (contraceptive) implant system, including implants and supplies Short Description: Levonorgestrel implant sys Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January …

Contraceptive supply, hormone containing patch, each Short Description: Contraceptive hormone patch Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: January 1, 2005 …

Contraceptive supply, hormone containing vaginal ring, each Short Description: Contraceptive vaginal ring Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: January 1, …

Levonorgestrel-releasing intrauterine contraceptive system, 52 mg Short Description: Levonorgestrel iu 52 mg Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: January 1, …

Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg Short Description: Skyla, 13.5 mg Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: January 1, …