HCPCS Code Details - J1817

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J1817
Description

Long description:
Insulin for administration through dme (i.e., insulin pump) per 50 units

Short description:
Insulin for insulin pump use

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code D1G - Drugs Administered through DME
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 - J1817

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 50 UNITS 7.556 - - - - - -
January 1, 2024 - March 31, 2024 50 UNITS 7.959 - - - - - -
October 1, 2023 - December 31, 2023 50 UNITS 8.302 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 50 UNITS 8.395 20% - - - - -
April 1, 2023 - June 30, 2023 50 UNITS 8.737 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”