HCPCS Code Details - J7504

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7504
Description

Long description:
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg

Short description:
Lymphocyte immune globulin

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, 2008 - 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, 2002
Date added Added Jan 01, 1988
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 - J7504

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 250 MG 3614.804 - - - - - -
January 1, 2024 - March 31, 2024 250 MG 3591.458 - - - - - -
October 1, 2023 - December 31, 2023 250 MG 3254.873 16.8337324697173% - - - - -
Jul 1, 2023 - Sep 30, 2023 250 MG 2989.437 18.075% - - - - -
April 1, 2023 - June 30, 2023 250 MG 3001.29 17.83% - - - - -

See also

  • HCPCS J7503 · Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg

  • HCPCS J7511 · Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg

  • HCPCS J7505 · Muromonab-cd3, parenteral, 5 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”