HCPCS Code Details - J0289

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J0289
Description

Long description:
Injection, amphotericin b liposome, 10 mg

Short description:
Amphotericin b liposome inj

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code D - Special coverage instructions apply
ASC payment group code Effective Jan 01, 2008 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2003
Date added Added Jan 01, 2003
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - J0289

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2024 - June 30, 2024 10 MG 27.682 - - - - - -
January 1, 2024 - March 31, 2024 10 MG 26.658 - - - - - -
October 1, 2023 - December 31, 2023 10 MG 27.923 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 10 MG 27.871 20% - - - - -
April 1, 2023 - June 30, 2023 10 MG 26.851 20% - - - - -

See also

  • HCPCS J0285 · Injection, amphotericin b, 50 mg

  • HCPCS J0287 · Injection, amphotericin b lipid complex, 10 mg

  • HCPCS J0288 · Injection, amphotericin b cholesteryl sulfate complex, 10 mg

  • HCPCS J0290 · Injection, ampicillin sodium, 500 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”