HCPCS Code Details - J1120

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J1120
Description

Long description:
Injection, acetazolamide sodium, up to 500 mg

Short description:
Acetazolamid sodium injectio

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, 1982
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 - J1120

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
500 MG 26.234 - - - - - -
January 1, 2024 - March 31, 2024 500 MG 28.119 - - - - - -
October 1, 2023 - December 31, 2023 500 MG 26.316 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 500 MG 29.702 20% - - - - -
April 1, 2023 - June 30, 2023 500 MG 29.01 20% - - - - -

See also

  • HCPCS J1110 · Injection, dihydroergotamine mesylate, per 1 mg

  • HCPCS J1130 · Injection, diclofenac sodium, 0.5 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”