Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

J7500 - J7599  Immunosuppressive Drugs (Includes Non-injectibles)

J7500
Azathioprine, oral, 50 mg
shortAzathioprine oral 50mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH15.03 Date of Service Edit: ClinicalPrescribing Information
DME450.03 Date of Service Edit: ClinicalPrescribing Information
J7501
Azathioprine, parenteral, 100 mg
shortAzathioprine parenteral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
OPH8.03 Date of Service Edit: ClinicalPrescribing Information
DME8.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
J7502
Cyclosporine, oral, 100 mg
shortCyclosporine oral 100 mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH60.03 Date of Service Edit: ClinicalClinical: Data
DME240.03 Date of Service Edit: ClinicalClinical: Data
J7503
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
shortTacrol envarsus ex rel oral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH120.03 Date of Service Edit: ClinicalPrescribing Information
DME3600.03 Date of Service Edit: ClinicalPrescribing Information
J7504
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
shortLymphocyte immune globulin
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA15.03 Date of Service Edit: ClinicalPrescribing Information
OPH15.03 Date of Service Edit: ClinicalPrescribing Information
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
J7505
Muromonab-cd3, parenteral, 5 mg
shortMonoclonal antibodies
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalPrescribing Information
OPH1.03 Date of Service Edit: ClinicalPrescribing Information
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
J7506
Prednisone, oral, per 5 mg
shortPrednisone oral
J7507
Tacrolimus, immediate release, oral, 1 mg
shortTacrolimus imme rel oral 1mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH40.03 Date of Service Edit: ClinicalPrescribing Information
DME1200.03 Date of Service Edit: ClinicalPublished Contractor Policy
J7508
Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
shortTacrol astagraf ex rel oral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH300.03 Date of Service Edit: ClinicalPrescribing Information
DME9000.03 Date of Service Edit: ClinicalPrescribing Information
J7509
Methylprednisolone oral, per 4 mg
shortMethylprednisolone oral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH60.03 Date of Service Edit: ClinicalPrescribing Information
DME360.03 Date of Service Edit: ClinicalClinical: Data
J7510
Prednisolone oral, per 5 mg
shortPrednisolone oral per 5 mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH60.03 Date of Service Edit: ClinicalPrescribing Information
DME240.03 Date of Service Edit: ClinicalClinical: Data
J7511
Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
shortAntithymocyte globuln rabbit
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA9.03 Date of Service Edit: ClinicalPrescribing Information
OPH9.03 Date of Service Edit: ClinicalPrescribing Information
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
J7512
Prednisone, immediate release or delayed release, oral, 1 mg
shortPrednisone ir or dr oral 1mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH300.03 Date of Service Edit: ClinicalPrescribing Information
DME7000.03 Date of Service Edit: ClinicalPrescribing Information
J7513
Daclizumab, parenteral, 25 mg
shortDaclizumab, parenteral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalDrug discontinued
OPH0.03 Date of Service Edit: ClinicalDrug discontinued
DME0.03 Date of Service Edit: ClinicalDrug discontinued
J7515
Cyclosporine, oral, 25 mg
shortCyclosporine oral 25 mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH90.03 Date of Service Edit: ClinicalClinical: Data
DME600.03 Date of Service Edit: ClinicalClinical: Data
J7516
Cyclosporin, parenteral, 250 mg
shortCyclosporin parenteral 250mg
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: Data
OPH4.03 Date of Service Edit: ClinicalPrescribing Information
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
J7517
Mycophenolate mofetil, oral, 250 mg
shortMycophenolate mofetil oral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH16.03 Date of Service Edit: ClinicalClinical: Data
DME480.03 Date of Service Edit: ClinicalClinical: Data
J7518
Mycophenolic acid, oral, 180 mg
shortMycophenolic acid
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH12.03 Date of Service Edit: ClinicalClinical: Society Comment
DME360.03 Date of Service Edit: ClinicalClinical: Society Comment
J7520
Sirolimus, oral, 1 mg
shortSirolimus, oral
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalOral Medication; Not Payable
OPH40.03 Date of Service Edit: ClinicalPrescribing Information
DME600.03 Date of Service Edit: ClinicalClinical: Data
J7525
Tacrolimus, parenteral, 5 mg
shortTacrolimus injection
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA2.03 Date of Service Edit: ClinicalPrescribing Information
OPH2.03 Date of Service Edit: ClinicalPrescribing Information
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
J7527
Everolimus, oral, 0.25 mg
shortOral everolimus
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH20.03 Date of Service Edit: ClinicalClinical: Data
DME960.03 Date of Service Edit: ClinicalClinical: Data
J7599
Immunosuppressive drug, not otherwise classified
shortImmunosuppressive drug noc
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
OPH1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup