HCPCS Code Details - J7639

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7639
Description

Long description:
Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram

Short description:
Dornase alfa non-comp unit

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
BETOS2 code D1G - Drugs Administered through DME
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2009
Date added Added Jan 01, 2000
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 - J7639

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
1 MG 52.034 - - - - - -
January 1, 2024 - March 31, 2024 1 MG 52.077 - - - - - -
October 1, 2023 - December 31, 2023 1 MG 52.254 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 1 MG 52.234 20% - - - - -
April 1, 2023 - June 30, 2023 1 MG 50.077 20% - - - - -

See also

  • HCPCS J7638 · Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram

  • HCPCS J7640 · Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms


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”