HCPCS code J1572 — Flebogamma injection. Status: Active. Effective Jan 1, 2009. Source: CMS HCPCS Level II.

J1572

Active

Flebogamma injection

Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jan 1, 2009
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 0947

MUE — Medically Unlikely Edits

Maximum units of J1572 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 180
Outpatient Hospital 180
Practitioner Services 180

Source: CMS Medicare NCCI Medically Unlikely Edits