HCPCS Code Details - J2788

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J2788
Description

Long description:
Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)

Short description:
Rho d immune globulin 50 mcg

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, 2014
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 - J2788

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 MCG (250 IU) 21.878 - - - - - -
January 1, 2024 - March 31, 2024 50 MCG (250 IU) 23.799 - - - - - -
October 1, 2023 - December 31, 2023 50 MCG (250 IU) 25.51 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 50 MCG (250 IU) 26.918 20% - - - - -
April 1, 2023 - June 30, 2023 50 MCG (250 IU) 25.472 20% - - - - -

See also

  • HCPCS J2787 · Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml

  • HCPCS J2790 · Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)

  • HCPCS J2792 · Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu


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”