HCPCS Code Section: HCPCS J Codes

Injection, basiliximab, 20 mg Short Description: Basiliximab Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2006 Effective Date: January 1, …

Injection, baclofen, 50 mcg for intrathecal trial Short Description: Baclofen intrathecal trial Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Injection, baclofen, 10 mg Short Description: Baclofen 10 mg injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1994 Effective …

Injection, dimercaprol, per 100 mg Short Description: Dimecaprol injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1982 Effective Date: …

Injection, atropine sulfate, 0.01 mg Short Description: Atropine sulfate injection Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2010 Effective …

Buprenorphine implant, 74.2 mg Short Description: Buprenorphine implant 74.2mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2017 Effective Date: January 1, …

Injection, azithromycin, 500 mg Short Description: Azithromycin Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2000 Effective Date: January 1, …

Injection, cerliponase alfa, 1 mg Short Description: Inj., cerliponase alfa 1 mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective …

Injection, aripiprazole, extended release, 1 mg Short Description: Inj aripiprazole ext rel 1mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2014 …

Injection, bezlotoxumab, 10 mg Short Description: Inj, bezlotoxumab, 10 mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2018 Effective Date: January …