HCPCS Code Details - J0476

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J0476
Description

Long description:
Injection, baclofen, 50 mcg for intrathecal trial

Short description:
Baclofen intrathecal trial

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
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, 2019
Date added Added Jan 01, 1999
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 - J0476

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
50 MCG 57.913 - - - - - -
January 1, 2024 - March 31, 2024 50 MCG 37.444 - - - - - -
October 1, 2023 - December 31, 2023 50 MCG 46.921 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 50 MCG 44.966 20% - - - - -
April 1, 2023 - June 30, 2023 50 MCG 61.493 20% - - - - -

See also


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”