HCPCS Code Details - J1205

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J1205
Description

Long description:
Injection, chlorothiazide sodium, per 500 mg

Short description:
Chlorothiazide sodium inj

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 O1E - Other drugs
HCPCS Action code P - Payment change (MOG, pricing indicator codes, anesthesia base units,Ambulatory Surgical Centers)
Type of service 1 - Medical care
Effective date Effective Jan 01, 2018
Date added Added Jan 01, 1982
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 - J1205

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2018 - December 31, 2018 500 MG 67.674 - - - - - -
July 1, 2018 - September 30, 2018 500 MG 75.313 - - - - - -
April 1, 2018 - June 30, 2018 500 MG 49.562 - - - - - -
January 1, 2018 - March 31, 2018 500 MG 61.487 - - - - - -
October 1, 2017 - December 31, 2017 500 MG 60.935 - - - - - -

See also

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

  • HCPCS J1212 · Injection, dmso, dimethyl sulfoxide, 50%, 50 ml


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”