HCPCS Code Details - J3245

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J3245
Description

Long description:
Injection, tildrakizumab, 1 mg

Short description:
Inj., tildrakizumab, 1 mg

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 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, 2019
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 - J3245

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 1 MG 140.227 - - - - - -
January 1, 2024 - March 31, 2024 1 MG 140.655 - - - - - -
October 1, 2023 - December 31, 2023 1 MG 142.222 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 1 MG 143.265 20% - - - - -
April 1, 2023 - June 30, 2023 1 MG 137.827 20% - - - - -

See also

  • HCPCS J3244 · Injection, tigecycline (accord) not therapeutically equivalent to j3243, 1 mg

  • HCPCS J3246 · Injection, tirofiban hcl, 0.25 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”