HCPCS Code Details - J7205

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7205
Description

Long description:
Injection, factor viii fc fusion protein (recombinant), per iu

Short description:
Factor viii fc fusion recomb

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
ASC payment group code Effective Jan 01, 2016 - This procedure is approved to be performed in an ambulatory surgical center.
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, 2016
Date added Added Jan 01, 2016
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 - J7205

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 IU 2.206 - - - - - - 1
January 1, 2024 - March 31, 2024 1 IU 2.188 - - - - - - 1
October 1, 2023 - December 31, 2023 1 IU 2.18 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 1 IU 2.173 20% - - - - -
April 1, 2023 - June 30, 2023 1 IU 2.176 20% - - - - -

See also

  • HCPCS C9136 · Injection, factor viii, fc fusion protein, (recombinant), per i.u.

  • HCPCS C9137 · Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.

  • HCPCS C9138 · Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.

  • HCPCS C9140 · Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.

  • HCPCS C9141 · Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u.

  • HCPCS J7182 · Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu

  • HCPCS J7185 · Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.

  • HCPCS J7188 · Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.

  • HCPCS J7204 · Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu

  • HCPCS J7207 · Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.

  • HCPCS J7208 · Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.

  • HCPCS J7209 · Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.

  • HCPCS J7210 · Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.

  • HCPCS J7211 · Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.

  • HCPCS J7214 · Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.


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”