HCPCS Code Details - J9226

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J9226
Description

Long description:
Histrelin implant (supprelin la), 50 mg

Short description:
Supprelin la implant

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 O1D - Chemotherapy
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, 2023
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 - J9226

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
January 1, 2023 - March 31, 2023 50 MG 43324.603 - - - - - -
October 1, 2022 - December 31, 2022 50 MG 38268.923 - - - - - -
Jul 1, 2022 - Sep 30, 2022 50 MG 42302.581 - - - - - -
April 1, 2022 - June 30, 2022 50 MG 42802.123 - - - - - -
January 1, 2022 - March 31, 2022 50 MG 43442.326 - - - - - -

See also


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”