J1554 HCPCS - INJECTION, IMMUNE GLOBULIN (ASCENIV), 500 MG

Code Information

Berenson-Eggers Type Of Service Code: O1E - Other drugs
Type Of Service Code:
- 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
- P - Lump sum purchase of DME, prosthetics, orthotics

Pricing Indicator Code:
- 51 - Drugs
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: C - Carrier judgment
ASC Payment Group Effective Date: 4/1/2021

Field Name	Field Value
Healthcare Common Procedure Coding System Code	J1554
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. asceniv
HCPCS Pricing Indicator Code 1	51 - Drugs
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS ASC Payment Group Code	YY
HCPCS ASC Payment Group Effective Date	4/1/2021
HCPCS Berenson-Eggers Type Of Service Code	O1E - Other drugs
HCPCS Type Of Service Code 1	1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
HCPCS Type Of Service Code 2	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	4/1/2021
HCPCS Action Effective Date	4/1/2021
HCPCS Action Code	N - No maintenance for this code