HCPCS Code Details - J2791

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J2791
Description

Long description:
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu

Short description:
Rhophylac 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
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, 2016
Date added Added Jan 01, 2008
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 - J2791

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
Jul 1, 2021 - Sep 30, 2021 100 IU 4.702 - - - - - -
April 1, 2021 - June 30, 2021 100 IU 4.753 - - - - - -
January 1, 2021 - March 31, 2021 100 IU 4.746 - - - - - -
October 1, 2020 - December 31, 2020 100 IU 4.732 - - - - - -
July 1, 2020 - September 30, 2020 100 IU 4.751 - - - - - -

See also

  • HCPCS J2790 · Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)

  • HCPCS J2792 · Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu


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”