HCPCS code J0791 — Inj crizanlizumab-tmca 5mg. Status: Active. Effective Jul 1, 2020. Source: CMS HCPCS Level II.

J0791

Active

Inj crizanlizumab-tmca 5mg

Injection, crizanlizumab-tmca, 5 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jul 1, 2020
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9359

MUE — Medically Unlikely Edits

Maximum units of J0791 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
Outpatient Hospital 160
Practitioner Services 160

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
00078-0883-61 Adakveo

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2020-Q3
    Inj crizanlizumab-tmca 5mg