Updated The following are J Code requirements September 2021 J Codes Auth Required? 20610 - Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa) No
A9513 - Lutetium Lu 177, dotatate, therapeutic, 1 mCi Yes A9579 - Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml No
C9036 - Injection, patisiran, 0.1 mg Yes
C9062 - Injection, daratumumab 10 mg and hyaluronidase-fihj Yes
C9064 - Mitomycin pyelocalyceal instillation, 1 mg Yes
C9065 - Injection, romidepsin, non-lypohilized (e.g. liquid), 1mg Yes
C9066 - Injection, sacituzumab govitecan-hziy, 10 mg Yes C9069 - Injection, belantamab mafodontin-blmf, 0.5 mg Yes C9070 - Injection, tafasitamab-cxix, 2 mg Yes C9071 - Injection, viltolarsen, 10 mg Yes C9072 - Injection, immune globulin (asceniv), 500 mg Yes C9073 - Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose Yes
C9074 - Injection, lumasiran, 0.5 mg Yes J0129 - Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician) Yes
J0131 - Injection, Acetaminophen, 10 mg No
J0133 - Injection, acyclovir, 5 mg No J0150 - Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use A9270) No
J0171 - Injection, Adrenalin, epinephrine, 0.1 mg No
J0178 - Injection, aflibercept, 1 mg No
J0485 - Injection, belatacept, 1 mg Yes
J0490 - Injection, belimumab, 10 mg Yes
J0558 - Injection, penicillin G benzathine and penicillin G procaine, 100,000 units No J0561 - Injection, penicillin G benzathine, 100,000 units No
J0567 - INJECTION CERLIPONASE ALFA 1 MG Yes
J0585 - Injection, onabotulinumtoxinA, 1 unit Yes
J0586 - Injection, abobotulinumtoxina, 5 units Yes
J0588 -Injection, incobotulinumtoxin a, 1 unit Yes
J0592 - Injection, buprenorphine HCl, 0.1 mg No
J0594 - Injection, busulfan, 1 mg No
J0604 - Cinacalcet, oral, 1 mg No
J0610 - Injection, calcium gluconate, per 10 ml No
J0640 - Injection, leucovorin calcium, per 50 mg No
J0641 - Injection, levoleucovorin calcium, 0.5 mg No
J0670 - Injection, mepivacaine HCl, per 10 ml No
J0690 - Injectoin, Cefazolin Sodium, 500 MG No
J0693 - Injection, cefiderocol, 5 mg Yes
J0696 - Injection, ceftriaxone sodium, per 250 mg No J0702 - Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg No
J0718 - Injection, certolizumab pegol, 1 mg Yes
J0735 - Injection, clonidine HCl, 1 mg No
J0775 - Injection, collagenase, clostridium histolyticum, 0.01 mg Yes
J0834 - Injection, cosyntropin (Cortrosyn), 0.25 mg No
J0878 - Injection, daptomycin, 1 mg No
J0881 - Injection, darbepoetin alfa, 1 mcg (non-ESRD use) No
J0894 - Injection, decitabine, 1 mg No
J0897 - Injection, denosumab, 1 mg Yes
J0900 - Injection, testosterone enanthate and estradiol valerate, up to 1 cc No
J1000 - Injection, depo-estradiol cypionate, up to 5 mg No
J1020 - Injection, methylprednisolone acetate, 20 mg No J1030 - Injection, methylprednisolone acetate, 40 mg No
J1040 - Injection, methylprednisolone acetate, 80 mg No
J1050 - Injection, medroxyprogesterone acetate, 1 mg No
J1051 - Injection, medroxyprogesterone acetate, 50 mg No
J1055 - Injection, medroxyprogesterone acetate for contraceptive use, 150 mg No
J1060 - Injection, testosterone cypionate and estradiol cypionate, up to 1 ml No
J1070 - Injection, testosterone cypionate, up to 100 mg No
J1080 - Injection, testosterone cypionate, 1 cc, 200 mg No
J1094 - Injection, dexamethasone acetate, 1 mg No
J1100 - Injection, dexamethasone sodium phosphate, 1 mg No
J1170 - Injection, hydromorphone, up to 4 mg No
J1200 - Injection, diphenhydramine HCl, up to 50 mg No
J1212 - Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml No
J1250 - Injection, Dobutamine HCl, per 250 mg No
J1300 - Injection, eculizumab, 10 mg Yes
J1335 - Injection, ertapenem sodium, 500 mg No
J1410 - Injection, estrogen conjugated, per 25 mg No
J1427 - Injection, viltolarsen, 10 mg Yes
J1428 - Injection, eteplirsen, 10 mg Yes
J1437 - Injection, ferric derisomaltose, 10 mg Yes
J1438 - INJECTION ETANERCEPT 25 MG Yes
J1439 - Injection Ferric carboxymaltose, per 1mg Yes
J1442 - Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram No
J1443 - Injection, ferric pyrophosphate citrate solution, 0.1 mg Yes
J1444 - Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron Yes
J1450 - Injection, fluconazole, 200 mg No
J1453 - INJECTION FOSAPREPITANT 1 MG No J1460 - Injection, gamma globulin, intramuscular, 1 cc No
J1554 - Injection, immune globulin (Asceniv), 500 mg Yes J1561 - Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg Yes J1572 - Injection, immune globulin, (Flebogamma/Flebogamma Dif), intravenous, nonlyophilized (e.g., liquid), 500 mg Yes
J1626 - Injection, granisetron HCl, 100 mcg No
J1631 - Injection, haloperidol decanoate, per 50 mg No
J1632 - Injection, brexanolone, 1 mg Yes
J1644 - Injection, Heparin sodium, per 1000 units No
J1650 - Injection, enoxaparin sodium, 10 mg No
J1720 - Injection, hydrocortisone sodium succinate, up to 100 mg No
J1725 - Injection, hydroxyprogesterone caproate, 1 mg No
J1738 - Injection, meloxicam, 1 mg Yes
J1745 - Injection infliximab, 10 mg Yes
J1750 - Injection, iron dextran, 50 mg Yes
J1756 - Injection, iron sucrose, 1 mg Yes
J1823 - Injection, inebilizumab-cdon, 1 mg Yes
J1885 - Injection, ketorolac tromethamine, per 15 mg No
J1940 - Injection, furosemide, up to 20 mg No
J1950 - Injection Leuprolide 3.75mg Yes
J2001 - Injection, lidocaine HCl for intravenous infusion, 10 mg No
J2060 - Injection, lorazepam, 2 mg No
J2175 - Injection, meperidine HCl, per 100 mg No
J2180 - Injection, meperidine and promethazine HCl, up to 50 mg No
J2182 - Injection, mepolizumab, 1 mg Yes
J2248 - Injection, micafungin sodium, 1 mg Yes
J2250 - Injection, midazolam HCl, per 1 mg No
J2270 - Injection, morphine sulfate, up to 10 mg No J2275 - Injection, morphine sulfate (preservative-free sterile solution), per 10 mg No
J2300 - Injection, nalbuphine HCl, per 10 mg No
J2315 - Injection, naltrexone, depot form, 1 mg No
J2323 - Injection, natalizumab, 1 mg Yes
J2326 - Injection, nusinersen, 0.1 mg Yes
J2350 - Injection, ocrelizumab, 1 mg Yes
J2353 - Injection, octreotide, depot form for intramuscular injection, 1 mg No
J2357 - Injection, omalizumab, 5 mg Yes
J2405 - Injection, ondansetron HCl, per 1 mg No
J2407 - Injection, oritavancin, 10 mg Yes
J2425 - Injection, palifermin, 50 mcg No
J2426 - Injection, paliperidone palmitate extended release, 1 mg No
J2430 - Injection, pamidronate disodium, per 30 mg Yes
J2469 - Injection, palonosetron HCl, 25 mcg No
J2505 - Injection, pegfilgrastim, 6 mg No
J2507 - Injection, pegloticase, 1 mg ( Pegloticase injection ) Yes
J2550 - Injection, promethazine HCl, up to 50 mg No
J2675 - Injection, progesterone, per 50 mg No
J2778 - Injection, ranibizumab, 0.1 mg No
J2780 - Injection, ranitidine HCl, 25 mg No
J2785 - Injection, regadenoson, 0.1 mg No
J2788 - Injection, Rho D immune globulin, human, minidose, 50 mcg (250 i.u.) No
J2790 - Injection, Rho D immune globulin, human, full dose, 300 mcg (1500 i.u.) No
J2794 - Injection, risperidone, long acting, 0.5 mg No
J2795 - Injection, ropivacaine HCl, 1 mg No
J2800 - Injection, methocarbamol, up to 10 ml No
J2805 - Injection, sincalide, 5 mcg No J2860 - Injection, siltuximab, 10 mg Yes
J2916 - Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg Yes
J2920 - Injection, methylprednisolone sodium succinate, up to 40 mg No
J2930 - Injection, methylprednisolone sodium succinate, up to 125 mg No
J2950 - Injection, promazine HCl, up to 25 mg No
J2997 - Injection, alteplase recombinant, 1 mg No
J3010 - Injection, fentanyl citrate, 0.1 mg No
J3030 - INJECTION SUMATRIPTAN SUCCINATE 6 MG No
J3032 - Injection, eptinezumab-jjmr, 1 mg Yes
J3105 - Injection, terbutaline sulfate, up to 1 mg No
J3120 - Injection, testosterone enanthate, up to 100 mg No
J3140 - Injection, testosterone suspension, up to 50 mg No
J3150 - Injection, testosterone propionate, up to 100 mg No
J3240 - Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial No
J3241 - Injection, teprotumumab-trbw, 10 mg Yes
J3262 - Injection, tocilizumab, 1 mg Yes
J3285 - Injection, treprostinil, 1 mg Yes
J3300 - Injection, triamcinolone acetonide, preservative free, 1 mg No
J3301 - Injection, triamcinolone acetonide, not otherwise specified, 10 mg No
J3303 - Injection, triamcinolone hexacetonide, per 5 mg No
J3357 - Injection, ustekinumab, 1 mg Yes
J3370 - Injection, vancomycin HCl, 500 mg No
J3380 - Injection, vedolizumab, 1 mg Yes
J3398 - Injection, voretigene neparvovec-rzyl, 1 billion vector genomes Yes
J3399 - Injection, Zolgensma Onasemnogene abeparvovec-xioi Yes
J3410 - Injection, hydroxyzine HCl, up to 25 mg No
J3420 - Injection, vitamin B-12 cyanocobalamin, up to 1,000 mcg No J3475 - Injection, magnesium sulfate, per 500 mg No
J3480 - Injection, potassium chloride, per 2 mEq No
J3489- Injection, zoledronic acid (Zometa), 1 mg Yes
J3490 - Unclassified drugs Yes J7212 - Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram Yes
J7297 - Levonorgestrel-releasing intrauterine contraceptive system, 52 mg No
J7300 - Intrauterine copper contraceptive No
J7307 - Etonogestrel (contraceptive) implant system, including implant and supplies No
J7312 - Injection, dexamethasone, intravitreal implant, 0.1 mg No J7321 - Hyaluronan or derivative, Hyalgan or Supartz, for intra-articular injection, per dose Yes
J7323 - Hyaluronan or derivative, Euflexxa, for intra-articular injection, per dose Yes
J7324 - Hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose Yes J7325 - Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg Yes
J7326 - Hyaluronan or derivative, gel-one, for intra-articular injection, per dose Yes J7327 - Hyaluronan or derivative, monovisc, for intra-articular injection, per dose Yes
J7351 - Injection, bimatoprost, intracameral implant, 1 microgram Yes
J7352 - Afamelanotide implant, 1 mg Yes
J7402 - Mometasone furoate sinus implant, (Sinuva), 10 mcg Yes
J9000 - Injection, doxorubicin HCl, 10 mg No
J9001 - Injection, doxorubicin HCl, all lipid formulations, 10 mg No
J9002 - Injection, doxorubicin hydrochloride, liposomal, Doxil, 10 mg No
J9025 - Injection, azacitidine, 1 mg No
J9031 - Bcg (intravesical) per instillation No
J9035 - Injection, bevacizumab, 10 mg No
J9037 - Injection, belantamab mafodontin-blmf, 0.5 mg Yes
J9041 - Injection, bortezomib, 0.1 mg No
J9045 - Injection, carboplatin, 50 mg No J9055 - Injection, cetuximab, 10 mg No
J9060 - Injection, cisplatin, powder or solution, 10 mg No
J9070 - Cyclophosphamide, 100 mg No
J9100 - Injection, cytarabine, 100 mg No
J9144 - Injection, daratumumab, 10 mg and hyaluronidase-fihj Yes
J9153 - Injection, liposomal, 1 mg Yes
J9171 - Injection, docetaxel, 1 mg No
J9173 - Injection, durvalumab, 10 mg Yes
J9181 - Injection, etoposide, 10 mg No
J9185 - Injection, fludarabine phosphate, 50 mg No
J9190 - Injection, fluorouracil, 500 mg No
J9201 - Injection, gemcitabine HCl, 200 mg No
J9202 - Goserelin acetate implant, per 3.6 mg No
J9206 - Injection irinotecan 20 MG No
J9208 - Injection, ifosfamide, 1 g No
J9209 - Injection, mesna, 200 mg No
J9214 - Injection, interferon, alfa-2b, recombinant, 1 million units Yes
J9217 - Leuprolide acetate/Lupron (for depot suspension), 7.5 mg Yes
J9223 - Injection, lurbinectedin, 0.1 mg Yes
J9225 - Histrelin implant (vantas), 50 mg Yes
J9226 - Histrelin implant (supprelin la), 50 mg Yes
J9227 - Injection, isatuximab-irfc, 10 mg Yes
J9245 - Injection, melphalan hydrochloride, 50 mg Yes
J9260 - Methotrexate sodium, 50 mg No
J9263 - Injection, oxaliplatin, 0.5 mg No
J9265 - Injection, paclitaxel, 30 mg No
J9268 - Injection, pentostatin, 10 mg No J9281 - Mitomycin pyelocalyceal instillation, 1 mg Yes
J9304 - Injection, pemetrexed (pemfexy), 10 mg Yes
J9305 - Injection, pemetrexed, 10 mg No
J9310 - Injection, rituximab, 100 mg Yes
J9316 - Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg Yes
J9317 - Injection, sacituzumab govitecan-hziy, 2.5 mg Yes
J9349 - Injection, tafasitamab-cxix, 2 mg Yes
J9351 - Injection, topotecan, 0.1 mg No
J9354 - Injection, ado-trastuzumab emtansine, 1 mg No
J9355 - Injection, trastuzumab, 10 mg No
J9356 - Injection, trastuzumab, 10 mg and Hyaluronidase-oysk Yes
J9370 - Vincristine sulfate, 1 mg No
J9395 - Injection, fulvestrant, 25 mg No M0239 - Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring Yes M1145 - Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier) Yes
Q0138 - Ferumoxytol, per 1mg (not on dialysis) Yes
Q0139 - Ferumoxytol, per 1mg (on dialysis) Yes
Q0239 - Injection, bamlanivimab, 700 mg Yes
Q0243 - Injection, casirivimab and imdevimab, 2400 mg Yes
Q0244 - Injection, casirivimab and imdevimab, 1200 mg Yes
Q0245 - Injection, bamlanivimab and etesevimab, 2100 mg Yes
Q0247 - Injection, sotrovimab, 500 mg Yes
Q2046 - Injection, aflibercept, 1 mg No Q2050 - Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg No
Q2051 - Injection, zoledronic acid, not otherwise specified, 1 mg Yes
Q2053 - BREXUCABTAGENE AUTOLCL AU ANTI-CD19 CAR P V T C Yes
Q2026 - Injection, radiesse, 0.1 ml Yes Q2028 - Injection, sculptra, 0.5 mg Yes
Q5103 - Injection, infliximab-dyyb, biosimilar (Inflectra), 10mg No
Q5104 - Injection, infliximab-abda, biosimilar (Renflexis), 10mg No
Q5107 - Injection, bevacizumab-awwb, biosimilar, (Mvasi), 10 mg No
Q5108 - Injection, pegfilgrastim-jmdb, biosimilar, (Fulphila), 0.5 mg No
Q5109 - Injection, infliximab-qbtx, biosimilar, (lxifi), 10 mg No
Q5110 - Injection, filgrastim-aafi, biosimilar (Nivestym), 1mcg No
Q5111 - Injection, pegfilgrastim-cbqv, biosimilar, (Udenyca), 0.5 m No
Q5112 - Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mg No
Q5113 - Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mg No
Q5114 - Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mg No
Q5115 - Injection, rituximab-abbs, biosimilar, (Truxima) 10 mg No
Q5116 - Injection, trastuzumab-qyyp biosimilar, (Trazimera), 10 mg No
Q5117 - Injection, trastuzumab-anns, biosimilar, (Kanjinti), 10 mg No
Q5118 - Injection, bevacizumab-bvcr, biosimilar, (Zirabev), 10 mg No
Q5119 - Injection, rituximab-pvvr, biosimilar, (RUXIENCE), 10 mg No
Q5120 - Injection, pegfilgrastim-bmez, biosimilar, (ZIEXTENZO), 0.5 mg No
Q5121 - Injection, infliximab-axxq, biosimilar, (AVSOLA), 10 mg No
Q5122 - Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg Yes
S0013 - Esketamine, nasal spray, 1 mg Yes
S0028 - Injection, famotidine, 20 mg No
Injection TEGSEDI (inotersen) (Currently Unclassified Drug J3490) Yes 90377 - Rabies immune globulin, heat- and solvent/detergent-treated (RIg-HT S/D), human, for intramuscular and/or subcutaneous use Yes