HCPCS Code Details - J7195

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7195
Description

Long description:
Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified

Short description:
Factor ix recombinant nos

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, 2015
Date added Added Jan 01, 2002
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 - J7195

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 1 IU 1.505 - - - - - - 1
July 1, 2018 - September 30, 2018 1 IU 1.511 - - - - - - 1
April 1, 2018 - June 30, 2018 1 IU 1.497 - - - - - - 1
January 1, 2018 - March 31, 2018 1 IU 1.51 - - - - - - 1
October 1, 2017 - December 31, 2017 1 IU 1.503 - - - - - - 1

See also

  • HCPCS J7194 · Factor ix, complex, per i.u.

  • HCPCS C9139 · Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.

  • HCPCS C9468 · Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, Rebinyn, 1 i.u.

  • HCPCS J7200 · Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu

  • HCPCS J7201 · Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.

  • HCPCS J7202 · Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.

  • HCPCS J7196 · Injection, antithrombin recombinant, 50 i.u.


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”