CPCA HCPCS Coding for Injectables 4

Question 1

A patient receives adalimumab 40 mg via subcutaneous injection. Which HCPCS code is reported?

Accepted Answer

J0135

Answer

J0135 is the HCPCS code for adalimumab injection, 20 mg, so 40 mg = 2 units of J0135.

Question 2

When billing HCPCS injectable codes, what does the term 'per dose' mean on the code descriptor?

Accepted Answer

The entire amount given in one administration encounter

Answer

Per dose means the entire amount administered in one encounter, typically a fixed single-use amount defined in the descriptor.

Question 3

Which HCPCS code covers infliximab injection, 10 mg?

Accepted Answer

J1745

Answer

J1745 is the HCPCS code for infliximab (Remicade), 10 mg per unit.

Question 4

Modifier JZ was introduced to indicate:

Accepted Answer

Zero waste was discarded from a single-dose vial

Answer

Modifier JZ certifies that no drug was wasted and no amount was discarded from a single-dose vial.

Question 5

A patient receives rituximab 500 mg IV. HCPCS J9312 is billed per 100 mg. How many units are reported?

Accepted Answer

5 units

Answer

500 mg divided by 100 mg per unit equals exactly 5 units of J9312.

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