HCPCS Code Section: HCPCS J Codes

Injection, onabotulinumtoxina, 1 unit Short Description: Injection,onabotulinumtoxina Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1991 Effective Date: January 1, …

Injection, burosumab-twza 1 mg Short Description: Injection, burosumab-twza 1m Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January 1, …

Injection, bivalirudin, 1 mg Short Description: Bivalirudin Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2004 Effective Date: January 1, 2018 Termination …

Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine Short Description: Bupren/nal over 10mg bupreno Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January …

Injection, edetate calcium disodium, up to 1000 mg Short Description: Edetate calcium disodium inj Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine Short Description: Bupren/nal 6.1 to 10mg bupre Coverage Code: Special coverage instructions apply Action …

Injection, c-1 esterase inhibitor (human), (haegarda), 10 units Short Description: Inj., haegarda 10 units Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine Short Description: Bupren/nal 3.1 to 6mg bupren Coverage Code: Special coverage instructions apply Action …

Injection, c-1 esterase inhibitor (human), cinryze, 10 units Short Description: C-1 esterase, cinryze Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2010 …

Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine Short Description: Bupren/nal up to 3mg bupreno Coverage Code: Special coverage instructions apply Action Code: No maintenance for this …