HCPCS code J1628 — Inj., guselkumab, 1 mg.
Status: Active.
Effective Jan 1, 2019.
Source: CMS HCPCS Level II.
J1628
ActiveInj., guselkumab, 1 mg
Injection, guselkumab, 1 mg
Category:
Drugs
Section:
J-codes: Drugs Administered Other Than Oral Method
Effective:
Jan 1, 2019
Code type:
alphanumeric
OPPS Status:
K
— Non-pass-through drugs and biologicals
OPPS APC:
9029
MUE — Medically Unlikely Edits
Maximum units of J1628 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 | 200 |
| Practitioner Services | 200 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NDC Crosswalk
National Drug Codes (NDCs) mapped to this HCPCS code.
| NDC | Drug Name |
|---|---|
| 57894-0640-01 | Tremfya |
| 57894-0640-06 | Tremfya |
| 57894-0640-11 | Tremfya |
| 57894-0650-02 | Tremfya IV |
| 57894-0651-02 | Tremfya |
| 57894-0651-04 | Tremfya |
| 57894-0651-22 | Tremfya |