HCPCS code J1426 — Injection, casimersen, 10 mg. Status: Active. Effective Oct 1, 2021. Source: CMS HCPCS Level II.

J1426

Active

Injection, casimersen, 10 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Oct 1, 2021
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9412

MUE — Medically Unlikely Edits

Maximum units of J1426 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 450
Practitioner Services 450

Source: CMS Medicare NCCI Medically Unlikely Edits

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 2021-Q4
    Injection, casimersen, 10 mg