HCPCS code J0289 — Amphotericin b liposome inj.
Status: Active.
Effective Jan 1, 2003.
Source: CMS HCPCS Level II.
J0289
ActiveAmphotericin b liposome inj
Injection, amphotericin b liposome, 10 mg
Category:
Drugs
Section:
J-codes: Drugs Administered Other Than Oral Method
Effective:
Jan 1, 2003
Code type:
alphanumeric
OPPS Status:
K
— Non-pass-through drugs and biologicals
OPPS APC:
0736
Drug class:
Antifungals
MUE — Medically Unlikely Edits
Maximum units of J0289 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 | 150 |
| Outpatient Hospital | 115 |
| Practitioner Services | 50 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NDC Crosswalk
National Drug Codes (NDCs) mapped to this HCPCS code.
| NDC | Drug Name |
|---|---|
| 00469-3051-30 | Ambisome |
| 23155-0594-31 | Amphotericin B Liposome |
| 55150-0365-01 | Amphotericin B Liposome |
| 62756-0233-01 | Amphotericin B Liposome |
| 67457-0926-50 | Amphotericin B Liposome |