HCPCS code J7196 — Antithrombin recombinant. Status: Active. Effective Jan 1, 2024. Source: CMS HCPCS Level II.

J7196

Active

Antithrombin recombinant

Injection, antithrombin recombinant, 50 i.u.

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jan 1, 2024
Code type: alphanumeric
OPPS Status: E2 — Items / services not covered by Medicare statute

MUE — Medically Unlikely Edits

Maximum units of J7196 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 175
Practitioner Services 175

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 2024-Q1
    Antithrombin recombinant