HCPCS Code Details - J1190

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J1190
Description

Long description:
Injection, dexrazoxane hydrochloride, per 250 mg

Short description:
Dexrazoxane hcl injection

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, 1997
Date added Added Jan 01, 1997
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 - J1190

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 250 MG 87.494 - - - - - -
Jul 1, 2024 - Sep 30, 2024 250 MG 100.665 - - - - - -
April 1, 2024 - June 30, 2024 250 MG 91.09 - - - - - -
January 1, 2024 - March 31, 2024 250 MG 108.006 - - - - - -
October 1, 2023 - December 31, 2023 250 MG 123.87906501449 20% - - - - -

See also

  • HCPCS J1180 · Injection, dyphylline, up to 500 mg

  • HCPCS J1200 · Injection, diphenhydramine hcl, up to 50 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”