HCPCS Code Details - J0174

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J0174
Description

Long description:
Injection, lecanemab-irmb, 1 mg

Short description:
Inj, lecanemab-irmb, 1 mg

HCPCS Modifier1
HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code C - Carrier judgment
ASC payment group code Effective Jul 06, 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 06, 2023
Date added Added Jul 06, 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 - J0174

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2024 - December 31, 2024 1 MG 1.336 - - - - - -
Jul 1, 2024 - Sep 30, 2024 1 MG 1.336 - - - - - -
April 1, 2024 - June 30, 2024 1 MG 1.339 - - - - - -
January 1, 2024 - March 31, 2024 1 MG 1.346 - - - - - -
October 1, 2023 - December 31, 2023 1 MG 1.35 20% - - - - -

See also

  • HCPCS J0173 · Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg

  • HCPCS J0175 · Injection, donanemab-azbt, 2 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”