HCPCS Code Details - J7686

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J7686
Description

Long description:
Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg

Short description:
Treprostinil, non-comp unit

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code D1G - Drugs Administered through DME
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2011
Date added Added Jan 01, 2011
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 - J7686

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
Jul 1, 2024 - Sep 30, 2024 1.74 MG 759.868 - - - - - -
April 1, 2024 - June 30, 2024 1.74 MG 725.266 - - - - - -
January 1, 2024 - March 31, 2024 1.74 MG 730.32 - - - - - -
October 1, 2023 - December 31, 2023 1.74 MG 733.638 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 1.74 MG 737.376 20% - - - - -

See also

  • HCPCS J7685 · Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams

  • HCPCS J7699 · Noc drugs, inhalation solution administered through dme


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”