HCPCS code J9394 — Inj, fulvestrant (fresenius). Status: Active. Effective Jan 1, 2023. Source: CMS HCPCS Level II.

J9394

Active

Inj, fulvestrant (fresenius)

Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jan 1, 2023
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9103

MUE — Medically Unlikely Edits

Maximum units of J9394 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 20
Outpatient Hospital 20
Practitioner Services 20

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

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

NDC Drug Name
63323-0715-05 Fulvestrant

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 2023-Q1
    Inj, fulvestrant (fresenius)