HCPCS code J1569 — Gammagard liquid injection.
Status: Active.
Effective Jan 1, 2013.
Source: CMS HCPCS Level II.
J1569
ActiveGammagard liquid injection
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg
Category:
Drugs
Section:
J-codes: Drugs Administered Other Than Oral Method
Effective:
Jan 1, 2013
Code type:
alphanumeric
OPPS Status:
K
— Non-pass-through drugs and biologicals
OPPS APC:
0944
Drug class:
IVIG (Intravenous Immune Globulin)
MUE — Medically Unlikely Edits
Maximum units of J1569 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 | 400 |
| Outpatient Hospital | 400 |
| Practitioner Services | 400 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NDC Crosswalk
National Drug Codes (NDCs) mapped to this HCPCS code.
| NDC | Drug Name |
|---|---|
| 00944-2700-02 | Gammagard Liquid |
| 00944-2700-03 | Gammagard Liquid |
| 00944-2700-04 | Gammagard Liquid |
| 00944-2700-05 | Gammagard Liquid |
| 00944-2700-06 | Gammagard Liquid |
| 00944-2700-07 | Gammagard Liquid |