HCPCS Code Details - J7213

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7213
Description

Long description:
Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.

Short description:
Inj, ixinity, 1 i.u.

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 Jul 01, 2023 - 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 Jul 01, 2023
Date added Added Jul 01, 2023
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 - J7213

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 1.838 - - - - - - 1
January 1, 2024 - March 31, 2024 1 IU 1.815 - - - - - - 1
October 1, 2023 - December 31, 2023 1 IU 1.764 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 1 IU 1.746 20% - - - - -

See also

  • HCPCS J7212 · Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram

  • HCPCS C9041 · Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg

  • HCPCS J7169 · Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg

  • 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”