HCPCS Code Details - J7316

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7316
Description

Long description:
Injection, ocriplasmin, 0.125 mg

Short description:
Inj, ocriplasmin, 0.125 mg

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jan 01, 2014 - 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, 2014
Date added Added Jan 01, 2014
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 - J7316

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2021 - June 30, 2021 0.125 MG 1046.927 - - - - - -
January 1, 2021 - March 31, 2021 0.125 MG 1046.927 - - - - - -
October 1, 2020 - December 31, 2020 0.125 MG 1046.927 - - - - - -
July 1, 2020 - September 30, 2020 0.125 MG 1046.927 - - - - - -
0.125 MG 1046.927 - - - - - -

See also

  • HCPCS J7315 · Mitomycin, ophthalmic, 0.2 mg

  • HCPCS J7318 · Hyaluronan or derivative, durolane, for intra-articular injection, 1 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”