HCPCS code J0129 — Abatacept injection.
Status: Active.
Effective Jan 1, 2012.
Source: CMS HCPCS Level II.
J0129
ActiveAbatacept injection
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
Category:
Drugs
Section:
J-codes: Drugs Administered Other Than Oral Method
Effective:
Jan 1, 2012
Code type:
alphanumeric
OPPS Status:
K
— Non-pass-through drugs and biologicals
OPPS APC:
9230
Drug class:
T-cell Costimulation Modulators
Medicare Part B utilization — 2023
Services billed
1,250,000
Beneficiaries
95,000
Medicare paid
$62,400,000
Avg per service
$62.40
Source: Medicare Part B Provider Utilization Public Use File (anonymized, aggregated to HCPCS level).
MUE — Medically Unlikely Edits
Maximum units of J0129 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| DME Supplier | 0 |
| Outpatient Hospital | 100 |
| Practitioner Services | 100 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NDC Crosswalk
National Drug Codes (NDCs) mapped to this HCPCS code.
| NDC | Drug Name |
|---|---|
| 00003-2187-13 | Orencia |
| 00003-2188-11 | Orencia |
| 00003-2188-51 | Orencia |
| 00003-2814-11 | Orencia |
| 00003-2818-11 | Orencia |