C9072 HCPCS - INJECTION, IMMUNE GLOBULIN (ASCENIV), 500 MG

Code Information

Berenson-Eggers Type Of Service Code: O1E - Other drugs
Type Of Service Code:
- 9 - Other medical items or services
- F - Ambulatory surgical center (facility usage for surgical services)

Pricing Indicator Code:
- 53 - Statute
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: D - Special coverage instructions apply

Field Name	Field Value
Healthcare Common Procedure Coding System Code	C9072
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Injection, immune globulin (asceniv), 500 mg
HCPCS Short Description	Inj, imm glob asceniv
HCPCS Pricing Indicator Code 1	53 - Statute
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Statute Number	1833(T)
HCPCS Cross Reference Code 1	J1554
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Berenson-Eggers Type Of Service Code	O1E - Other drugs
HCPCS Type Of Service Code 1	9 - Other medical items or services
HCPCS Type Of Service Code 2	F - Ambulatory surgical center (facility usage for surgical services)
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2021
HCPCS Action Effective Date	4/1/2021
HCPCS Termination Date	3/31/2021
HCPCS Action Code	N - No maintenance for this code