HCPCS Code Details - J3415

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J3415
Description

Long description:
Injection, pyridoxine hcl, 100 mg

Short description:
Pyridoxine hcl 100 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, 2004
Date added Added Jan 01, 2004
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 - J3415

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 100 MG 15.002 - - - - - -
January 1, 2024 - March 31, 2024 100 MG 14.825 - - - - - -
October 1, 2023 - December 31, 2023 100 MG 13.929 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 100 MG 15.897 20% - - - - -
April 1, 2023 - June 30, 2023 100 MG 5.623 20% - - - - -

See also

  • HCPCS J3411 · Injection, thiamine hcl, 100 mg

  • HCPCS J3420 · Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg


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”