HCPCS Code Details - J0743

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J0743
Description

Long description:
Injection, cilastatin sodium; imipenem, per 250 mg

Short description:
Cilastatin sodium injection

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, 1997
Date added Added Jan 01, 1993
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 - J0743

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
250 MG 7.561 - - - - - -
January 1, 2024 - March 31, 2024 250 MG 8.103 - - - - - -
October 1, 2023 - December 31, 2023 250 MG 7.925 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 250 MG 7.145 20% - - - - -
April 1, 2023 - June 30, 2023 250 MG 7.11992831318414 20% - - - - -

See also

  • HCPCS J0742 · Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg

  • HCPCS J0744 · Injection, ciprofloxacin for intravenous infusion, 200 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”