HCPCS code J7204 — Inj recombin esperoct per iu. Status: Active. Effective Jul 1, 2020. Source: CMS HCPCS Level II.

J7204

Active

Inj recombin esperoct per iu

Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jul 1, 2020
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9354

MUE — Medically Unlikely Edits

Maximum units of J7204 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 19500
Practitioner Services 19500

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
00169-8100-01 Esperoct
00169-8150-01 Esperoct
00169-8200-01 Esperoct
00169-8300-01 Esperoct
00169-8400-01 Esperoct
00169-8500-01 Esperoct

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 2020-Q3
    Inj recombin esperoct per iu