J7500 |
|
Azathioprine, oral, 50 mg
short | Azathioprine oral 50mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 15.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 450.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
J7501 |
|
Azathioprine, parenteral, 100 mg
short | Azathioprine parenteral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | OPH | 8.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 8.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
J7502 |
|
Cyclosporine, oral, 100 mg
short | Cyclosporine oral 100 mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 60.0 | 3 Date of Service Edit: Clinical | Clinical: Data | DME | 240.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7503 |
|
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
short | Tacrol envarsus ex rel oral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 3600.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
J7504 |
|
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
short | Lymphocyte immune globulin |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 15.0 | 3 Date of Service Edit: Clinical | Prescribing Information | OPH | 15.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 0.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
J7505 |
|
Muromonab-cd3, parenteral, 5 mg
short | Monoclonal antibodies |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 1.0 | 3 Date of Service Edit: Clinical | Prescribing Information | OPH | 1.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 0.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
J7506 |
|
Prednisone, oral, per 5 mg
|
|
J7507 |
|
Tacrolimus, immediate release, oral, 1 mg
short | Tacrolimus imme rel oral 1mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 40.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 1200.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
J7508 |
|
Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
short | Tacrol astagraf ex rel oral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 300.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 9000.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
J7509 |
|
Methylprednisolone oral, per 4 mg
short | Methylprednisolone oral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 60.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 360.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7510 |
|
Prednisolone oral, per 5 mg
short | Prednisolone oral per 5 mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 60.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 240.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7511 |
|
Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
short | Antithymocyte globuln rabbit |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 9.0 | 3 Date of Service Edit: Clinical | Prescribing Information | OPH | 9.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 0.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
J7512 |
|
Prednisone, immediate release or delayed release, oral, 1 mg
short | Prednisone ir or dr oral 1mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 300.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 7000.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
J7513 |
|
Daclizumab, parenteral, 25 mg
short | Daclizumab, parenteral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Drug discontinued | OPH | 0.0 | 3 Date of Service Edit: Clinical | Drug discontinued | DME | 0.0 | 3 Date of Service Edit: Clinical | Drug discontinued |
|
|
|
J7515 |
|
Cyclosporine, oral, 25 mg
short | Cyclosporine oral 25 mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 90.0 | 3 Date of Service Edit: Clinical | Clinical: Data | DME | 600.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7516 |
|
Cyclosporin, parenteral, 250 mg
short | Cyclosporin parenteral 250mg |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | OPH | 4.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 0.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
J7517 |
|
Mycophenolate mofetil, oral, 250 mg
short | Mycophenolate mofetil oral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 16.0 | 3 Date of Service Edit: Clinical | Clinical: Data | DME | 480.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7518 |
|
Mycophenolic acid, oral, 180 mg
short | Mycophenolic acid |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 12.0 | 3 Date of Service Edit: Clinical | Clinical: Society Comment | DME | 360.0 | 3 Date of Service Edit: Clinical | Clinical: Society Comment |
|
|
|
J7520 |
|
Sirolimus, oral, 1 mg
short | Sirolimus, oral |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | OPH | 40.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 600.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7525 |
|
Tacrolimus, parenteral, 5 mg
short | Tacrolimus injection |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 2.0 | 3 Date of Service Edit: Clinical | Prescribing Information | OPH | 2.0 | 3 Date of Service Edit: Clinical | Prescribing Information | DME | 0.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
J7527 |
|
Everolimus, oral, 0.25 mg
short | Oral everolimus |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 20.0 | 3 Date of Service Edit: Clinical | Clinical: Data | DME | 960.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
J7599 |
|
Immunosuppressive drug, not otherwise classified
short | Immunosuppressive drug noc |
RVU | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|