The Following Are J Code Requirements

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The Following Are J Code Requirements 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
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    EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2021 Anatomical Classification Guidelines V2021 "The Anatomical Classification of Pharmaceutical Products has been developed and maintained by the European Pharmaceutical Marketing Research Association (EphMRA) and is therefore the intellectual property of this Association. EphMRA's Classification Committee prepares the guidelines for this classification system and takes care for new entries, changes and improvements in consultation with the product's manufacturer. The contents of the Anatomical Classification of Pharmaceutical Products remain the copyright to EphMRA. Permission for use need not be sought and no fee is required. We would appreciate, however, the acknowledgement of EphMRA Copyright in publications etc. Users of this classification system should keep in mind that Pharmaceutical markets can be segmented according to numerous criteria." © EphMRA 2021 Anatomical Classification Guidelines V2021 CONTENTS PAGE INTRODUCTION A ALIMENTARY TRACT AND METABOLISM 1 B BLOOD AND BLOOD FORMING ORGANS 28 C CARDIOVASCULAR SYSTEM 36 D DERMATOLOGICALS 51 G GENITO-URINARY SYSTEM AND SEX HORMONES 58 H SYSTEMIC HORMONAL PREPARATIONS (EXCLUDING SEX HORMONES) 68 J GENERAL ANTI-INFECTIVES SYSTEMIC 72 K HOSPITAL SOLUTIONS 88 L ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS 96 M MUSCULO-SKELETAL SYSTEM 106 N NERVOUS SYSTEM 111 P PARASITOLOGY 122 R RESPIRATORY SYSTEM 124 S SENSORY ORGANS 136 T DIAGNOSTIC AGENTS 143 V VARIOUS 145 Anatomical Classification Guidelines V2021 INTRODUCTION The Anatomical Classification was initiated in 1971 by EphMRA. It has been developed jointly by Intellus/PBIRG and EphMRA. It is a subjective method of grouping certain pharmaceutical products and does not represent any particular market, as would be the case with any other classification system.
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