Drugs & Biologicals: Maximum Allowed Units (MAUs) – Palmetto GBA Medicare
cpt code and description
J1040 – Injection, methylprednisolone acetate, 80 mg
J1170 – Injection, hydromorphone, up to 4 mg
Maximum Allowed Units List
KEY
|
HCPCS Code
|
Code Description
|
MAU
|
Release Date
|
Reassesment
Date |
---|---|---|---|---|---|
J0129 | Injection, abatacept, 10 mg |
100 |
10/16/2008 | ||
J0150 | Injection, adenosine for therapeutic use, 6 mg | 5 | 10/16/2008 | 7/1/2010 | |
J0152 | Injection, adenosine for diagnostic use, 30 mg |
4 |
10/16/2008 | ||
J0170 | Injection, adrenalin, epinephrine, up to 1 ml ampul | 2 | 10/16/2008 | ||
J0180 | Injection, agalsidase beta, 1 mg | 105 | 10/16/2008 | ||
J0207 |
Injection, amifostine, 500 mg |
5 | 10/16/2008 | ||
J0215 | Injection, alefacept, 0.5 mg | 30 | 10/16/2008 | ||
5 | J0256 |
Injection, alpha 1-proteinase inhibitor-human, 10 mg |
3,000 | 10/16/2008 | 4/10/2009 |
J0270 | Injection, alprostadil, 1.25 mcg |
1 |
10/16/2008 | ||
J0275 | Alprostadil urethral suppository | 1 | 10/16/2008 | ||
J0278 | Injection, amikacin sulfate, 100 mg | 6 | 10/16/2008 | ||
J0280 |
Injection, aminophylline, up to 250 mg |
1 | 10/16/2008 | ||
J0282 | Injection, amiodarone hydrochloride, 30 mg | 20 | 10/16/2008 | ||
J0285 |
Injection, amphotericin B, 50 mg |
1 | 10/16/2008 | ||
J0288 | Injection, amphotericin B cholesteryl sulfate complex, 10 mg | 45 | 7/17/2009 | ||
J0289 | Injection, amphotericin B liposome, 10 mg | 30 | 10/16/2008 | ||
J0290 | Injection, ampicillin sodium, 500 mg | 4 |
10/16/2008 |
||
J0295 | Injection, ampicillin sodium/sulbactam sodium, per 1.5 gram | 4 | 10/16/2008 | ||
J0360 | Injection, hydralazine HCl, up to 20 mg | 1 |
10/16/2008 |
||
J0390 | Injection, chloroquine HCl, up to 250 mg | 4 | 10/16/2008 | ||
J0456 | Injection, azithromycin, 500 mg | 1 |
10/16/2008 |
||
9 |
J0460 | Injection, atropine sulfate, up to 0.3 mg | 4 | 10/16/2008 | |
J0461 | Injection, atropine sulfate, up to 0.01 mg | 120 | 1/1/2010 | ||
5 |
J0475 |
Injection, baclofen, 10 mg | 8 | 10/16/2008 | |
J0476 |
Injection, baclofen, 50 mcg for intrathecal trial |
2 | 10/16/2008 | ||
J0500 | Injection, dicyclomine HCl, up to 20 mg | 1 | 10/16/2008 | ||
J0515 |
Injection, benztropine mesylate, per 1 mg |
2 | 10/16/2008 | ||
9 | J0530 | Injection, penicillin G benzathine and penicillin G procaine, up to 600,000 units |
2 |
10/16/2008 | |
9 | J0540 | Injection, penicillin G benzathine and penicillin G procaine, up to 1,200,000 units | 2 | 10/16/2008 | |
9 | J0550 | Injection, penicillin G benzathine and penicillin G procaine, up to 2,400,000 units | 1 | 10/16/2008 | |
J0559 | Injection, penicillin G benzathine and penicillin G procaine, 2500 units | 960 | 1/1/2010 | ||
J0560 | Injection, penicillin G benzathine, up to 600,000 units |
4 |
10/16/2008 | 7/1/2010 | |
J0570 | Injection, penicillin G benzathine, up to 1,200,000 units | 2 |
10/16/2008 |
||
J0580 | Injection, penicillin G benzathine, up to 2,400,000 units | 1 | 10/16/2008 | ||
J0583 | Injection, bivalirudin, 1 mg | 250 |
10/16/2008 |
7/1/2010 | |
J0585 | Botulinum toxin type A, per unit | 600 | 11/18/2008 | 12/31/2008 | |
J0586 | Injection, abobotulinumtoxina, 5 units | 200 | 1/1/2010 | ||
J0587 |
Botulinum toxin type B, per 100 units | 250 | 10/16/2008 | 6/1/2010 | |
J0592 |
Injection, buprenorphine hydrochloride, 0.1mg |
3 | 10/16/2008 | ||
J0595 | Injection, butorphanol tartrate, 1 mg | 4 | 10/16/2008 | ||
J0598 | Injection, C1 esterase inhibitor (human), 10 units | 100 | 1/1/2010 | ||
J0600 | Injection, edetate calcium disodium, up to 1000 mg | 3 | 10/16/2008 | 7/1/2010 | |
J0610 | Injection, calcium gluconate, per 10 ml |
2 |
10/16/2008 | ||
J0637 | Injection, caspofungin acetate, 5 mg | 14 | 10/16/2008 | ||
J0640 | Injection, leucovorin calcium, per 50 mg | 24 | 10/16/2008 | ||
8 | J0641 |
Injection, levoleucovorin calcium, 0.5 mg |
200 | 12/16/2008 | |
J0670 | Injection, mepivacaine HCl, per 10 ml | 4 | 10/16/2008 | ||
J0690 |
Injection, cefazolin sodium, 500 mg |
12 | 10/16/2008 | 6/1/2010 | |
J0692 | Injection, cefepime hydrochloride, 500 mg |
8 |
10/16/2008 | ||
J0694 | Injection, cefoxitin sodium, 1 gram | 8 | 10/16/2008 | ||
J0696 | Injection, ceftriaxone sodium, per 250 mg | 16 | 10/16/2008 | ||
J0697 |
Injection, sterile cefuroxime sodium, per 750 mg |
4 | 10/16/2008 | ||
J0698 | Injection, cefotaxime sodium, per gm | 6 | 10/16/2008 | ||
J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate, per 3 mg |
4 | 10/16/2008 | Denied | |
J0704 | Injection, betamethasone sodium phosphate, per 4 mg |
5 |
10/16/2008 | ||
J0713 | Injection, ceftazidime, per 500 mg | 12 | 10/16/2008 | 6/1/2010 | |
J0715 | Injection, ceftizoxime sodium, per 500 mg |
8 |
11/7/2008 | ||
J0718 | Injection, certolizumab pegol, 1 mg | 400 | 1/1/2010 | Removed: self administered drug list | |
J0720 | Injection, chloramphenicol sodium succinate, up to 1 gm | 6 |
11/7/2008 |
||
5 |
J0735 | Injection, clonidine hydrochloride, 1 mg | 2 | 11/7/2008 |
7/1/2010 |
J0743 |
Injection, cilastatin sodium; imipenem, per 250 mg | 8 | 11/7/2008 | ||
J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
6 | 11/7/2008 | ||
J0780 | Injection, prochlorperazine, up to 10 mg | 4 | 11/7/2008 | ||
J0800 |
Injection, corticotropin, up to 40 units |
2 | 11/7/2008 | ||
J0833 | Injection, cosyntropin, not otherwise specified, 0.25 mg | 3 | 1/1/2010 | ||
J0834 | Injection, cosyntropin, (cortrosyn), 0.25 mg | 3 | 1/1/2010 | ||
9 |
J0835 |
Injection, cosyntropin, per 0.25 mg | 1 | 11/7/2008 | |
J0878 | Injection, daptomycin, 1 mg | 1000 | 11/7/2008 | ||
J0881 | Injection, darbepoetin alfa, 1 microgram (non-ESRD use) | 500 |
12/16/2008 |
||
J0882 | Injection, darbepoetin alfa, 1 microgram (for ESRD on dialysis) | 400 | 12/16/2008 | 7/1/2009 | |
J0885 | Injection, epoetin alfa, (for non-ESRD use), 1000 units | 60 |
12/16/2008 |
||
J0886 | Injection, epoetin alfa, 1000 units (for ESRD on dialysis) | 45 | 12/16/2008 | ||
J0894 | Injection, decitabine, 1 mg | 100 |
11/7/2008 |
||
J0895 | Injection, deferoxamine mesylate, 500 mg | 6 | 11/7/2008 | ||
J0900 | Injection, testosterone enanthate and estradiol valerate, up to 1 cc | 1 |
11/7/2008 |
4/1/2010 | |
J0945 | Injection, brompheniramine maleate, per 10 mg | 2 | 11/7/2008 | ||
J0970 | Injection, estradiol valerate, up to 40 mg | 1 |
11/7/2008 |
||
J1000 | Injection, depo-estradiol cypionate, up to 5 mg | 1 | 11/7/2008 | ||
J1020 | Injection, methylprednisolone acetate, 20 mg | 6 |
11/7/2008 |
||
J1030 | Injection, methylprednisolone acetate, 40 mg | 4 | 11/7/2008 | ||
J1040 | Injection, methylprednisolone acetate, 80 mg | 3 |
11/7/2008 |
||
J1051 | Injection, medroxyprogesterone acetate, 50 mg | 8 | 11/7/2008 | ||
2 | J1055 | Injection, medroxyprogesterone acetate for contraceptive use, 150 mg | 0 |
11/7/2008 |
|
J1060 | Injection, testosterone cypionate and estradiol cypionate, up to 1 ml | 1 | 11/7/2008 | 4/1/2010 | |
J1070 | Injection, testosterone cypionate, up to 100 mg | 4 |
11/7/2008 |
||
J1080 | Injection, testosterone cypionate, 1 cc, 200 mg | 2 | 11/7/2008 | ||
J1094 | Injection, dexamethasone acetate, 1 mg | 16 |
11/7/2008 |
||
J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 110 | 11/7/2008 | ||
J1110 | Injection, dihydroergotamine mesylate, per 1 mg | 3 |
11/7/2008 |
||
J1120 | Injection, acetazolamide sodium, up to 500 mg | 2 | 11/7/2008 | ||
J1160 | Injection, digoxin, up to 0.5 mg | 2 |
11/7/2008 |
||
J1162 | Injection, digoxin immune fab (ovine), per vial | 6 | 11/7/2008 | 7/1/2010 | |
J1165 | Injection, phenytoin sodium, per 50 mg | 35 |
11/7/2008 |
||
5 |
J1170 | Injection, hydromorphone, up to 4 mg | 300 | 11/7/2008 | |
J1180 | Injection, dyphylline, up to 500 mg | 1 |
11/7/2008 |
||
J1190 | Injection, dexrazoxane hydrochloride, per 250 mg | 5 | 11/7/2008 | ||
J1200 | Injection, diphenhydramine HCl, up to 50 mg | 8 |
11/7/2008 |
||
J1205 | Injection, chlorothiazide sodium, per 500 mg | 4 | 11/7/2008 | ||
J1212 | Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml | 1 |
11/7/2008 |
||
5 |
J1230 | Injection, methadone HCl, up to 10 mg | 10 | 11/7/2008 | |
J1240 | Injection, dimenhydrinate, up to 50 mg | 1 |
11/7/2008 |
||
J1245 | Injection, dipyridamole, per 10 mg | 6 | 11/7/2008 | ||
J1250 | Injection, dobutamine hydrochloride, per 250 mg | 2 | 7/17/2009 | ||
J1260 | Injection, dolasetron mesylate, 10 mg | 20 | 7/17/2009 | ||
8 | J1267 | Injection, doripenem, 10 mg |
100 |
12/16/2008 | |
J1300 | Injection, eculizumab, 10 mg | 90 | 7/17/2009 | ||
J1325 | Injection, epoprostenol, 0.5 mg | 1 |
12/16/2008 |
7/1/2010 | |
J1327 | Injection, eptifibatide, 5 mg | 4 | 12/16/2008 | ||
4 | J1330 | Injection, ergonovine maleate, up to 0.2 mg | 0 |
11/21/2008 |
|
J1335 | Injection, ertapenem sodium, 500 mg | 2 | 11/14/2008 | ||
J1364 | Injection, erythromycin lactobionate, per 500 mg | 5 |
12/16/2008 |
||
J1380 | Injection, estradiol valerate, up to 10 mg | 3 | 11/14/2008 | ||
J1390 | Injection, estradiol valerate, up to 20 mg | 2 |
11/14/2008 |
||
J1410 | Injection, estrogen conjugated, per 25 mg | 2 | 12/16/2008 | ||
J1435 | Injection, estrone, per 1 mg | 1 |
12/16/2008 |
7/1/2010 | |
J1440 | Injection, filgrastim (G-CSF), 300 mcg | 4 | 12/3/2008 | ||
J1441 | Injection, filgrastim (G-CSF), 480 mcg | 3 |
11/7/2008 |
||
J1450 | Injection, fluconazole, 200 mg | 6 | 11/14/2008 | ||
8 | J1453 | Injection, fosaprepitant, 1 mg | 115 |
12/16/2008 |
|
8 |
J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g. liquid), 500 mg | 220 | 12/16/2008 | |
J1460 | Injection, gamma globulin, intramuscular, 1cc | 1 | 4/1/2010 | ||
J1470 |
Injection, gamma globulin; intramuscular, 2 cc | 1 | 11/14/2008 | ||
J1480 | Injection, gamma globulin, intramuscular, 3 cc | 1 | 4/1/2010 | ||
J1490 | Injection, gamma globulin, intramuscular, 4 cc | 1 | 4/1/2010 | ||
J1500 | Injection, gamma globulin, intramuscular, 5 cc | 1 | 4/1/2010 | ||
J1510 | Injection, gamma globulin, intramuscular, 6 cc | 1 | 4/1/2010 | ||
J1520 | Injection, gamma globulin; intramuscular, 7 cc (gama stan ds) | 1 | 7/17/2009 | 4/1/2010 | |
J1530 | Injection, gamma globulin, intramuscular, 8 cc | 1 | 4/1/2010 | ||
J1540 | Injection, gamma globulin, intramuscular, 9 cc | 1 | 4/1/2010 | ||
J1550 |
Injection, gamma globulin; intramuscular, 10 cc |
1 | 11/14/2008 | 4/1/2010 | |
J1560 | Injection, gamma globulin, intramuscular, over 10 cc | 1 | 4/1/2010 | ||
J1561 | Injection, immune globulin, (gamunex), intravenous, non-lyophilized (e.g., liquid), 500 mg | 440 | 7/17/2009 | ||
J1562 | Injection, immune globulin, (vivaglobin), 100 mg | 220 | 7/17/2009 | ||
J1566 |
Injection, immune globulin, intravenous, lyophilized (e.g. powder), not otherwise specified, 500 mg |
440 | 12/16/2008 | ||
J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized, (e.g., liquid), 500 mg | 440 | 7/17/2009 | 12/28/2009 | |
J1569 | Injection, immune globulin, (gammagard liquid), intravenous, non-lyophilized, (e.g., liquid), 500 mg | 440 | 7/17/2009 | 12/28/2009 | |
J1570 | Injection, ganciclovir sodium, 500 mg | 2 | 7/17/2009 | ||
J1580 | Injection, garamycin, gentamicin, up to 80 mg | 5 | 12/16/2008 | ||
4 | J1590 | Injection, gatifloxacin, 10 mg |
0 |
11/14/2008 | |
J1600 | Injection, gold sodium thiomalate, up to 50 mg | 1 | 11/14/2008 | ||
J1610 | Injection, glucagon hydrochloride, per 1 mg | 1 | 11/14/2008 | ||
J1626 |
Injection, granisetron hydrochloride, 100 mcg |
11 | 12/3/2008 | ||
J1630 | Injection, haloperidol, up to 5 mg | 5 | 11/14/2008 | 7/1/2010 | |
J1631 |
Injection, haloperidol decanoate, per 50 mg |
2 | 11/14/2008 | ||
J1640 | Injection, hemin, 1 mg | 660 | 12/3/2008 | ||
J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
4 | 11/14/2008 | ||
J1644 | Injection, heparin sodium, per 1,000 units | 40 | 11/14/2008 | ||
J1645 |
Injection, dalteparin sodium, per 2500 IU |
9 | 12/3/2008 | ||
J1650 | Injection, enoxaparin sodium, 10 mg | 17 | 12/3/2008 | 2/27/2009 | |
J1652 |
Injection, fondaparinux sodium, 0.5 mg |
20 | 11/14/2008 | ||
J1655 | Injection, tinzaparin sodium, 1000 IU | 28 | 12/16/2008 | ||
J1670 |
Injection, tetanus immune globulin, human, up to 250 units |
1 | 11/14/2008 | ||
5 | J1680 | Injection, human fibrinogen concentrate, 100 mg | 78 | 1/1/2010 | |
4 |
J1710 | Injection, hydrocortisone sodium phosphate, up to 50 mg | 0 | 11/21/2008 | |
J1720 | Injection, hydrocortisone sodium succinate, up to 100 mg | 110 |
12/16/2008 |
||
J1740 | Injection, ibandronate sodium, 1 mg | 3 | 7/17/2009 | ||
J1743 | Injection, idursulfase, 1 mg | 55 | 7/17/2009 | ||
J1745 |
Injection, infliximab, 10 mg |
110 | 11/14/2008 | 12/2/2008 | |
8 | J1750 | Injection, iron dextran, 50 mg |
90 |
12/16/2008 | |
7 | J1751 | Injection, iron dextran 165, 50 mg | 90 | 12/16/2008 | |
7 | J1752 | Injection, iron dextran 267, 50 mg |
90 |
12/16/2008 | |
J1756 | Injection, iron sucrose, 1 mg | 500 | 12/3/2008 | 5/1/2009 | |
5 | J1785 | Injection, imiglucerase, per unit |
6600 |
12/16/2008 | |
J1790 | Injection, droperidol, up to 5 mg | 2 | 11/14/2008 | 7/1/2010 | |
J1800 | Injection, propranolol HCl, up to 1 mg |
6 |
12/16/2008 | ||
3 | J1815 | Injection, insulin, per 5 units | 0 | 11/14/2008 | |
J1817 | Insulin for administration through DME (i.e., Insulin pump) per 50 units | 5 | 12/16/2008 | ||
J1840 | Injection, kanamycin sulfate, up to 500 mg | 2 | 7/17/2009 | ||
J1850 | Injection, kanamycin sulfate, up to 75 mg | 4 | 7/1/2010 | ||
J1885 | Injection, ketorolac tromethamine, per 15 mg | 8 |
11/14/2008 |
||
8 |
J1930 | Injection, lanreotide, 1 mg | 120 | 12/16/2008 | |
J1940 | Injection, furosemide, up to 20 mg | 8 |
12/3/2008 |
6/1/2010 | |
J1950 | Injection, leuprolide acetate (for depot suspension), per 3.75 mg | 1 | 12/3/2008 | ||
8 | J1953 | Injection, levetiracetam, 10 mg | 150 |
12/16/2008 |
|
J1956 | Injection, levofloxacin, 250 mg | 3 | 11/14/2008 |
Guideline
Q: We are a solo practice looking for alternate sources of revenue. A semi-retired anesthesiologist has expressed interest in coming into our office weekly to do lumbar epidural steroid injections (ESIs). This seems like a good move for us since we refer out about 10 patients a week for these procedures. He will be performing only straightforward lumbar ESIs. How would we code for his services?
A: For the lumbar ESI itself you would bill CPT 62311, injection, single (not via indwelling catheter), not including neurolytic substance, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal). Depo-medrol comes in 20mg (J1020), 30mg (J1030), and 80 mg (J1040) vials. Other supplies used are generally included in the RVUs for the procedure and not billed separately.