HCPCS code A9552: FDG PET scan billing, coverage, and modifiers
HCPCS code A9552 is the Level II billing code for Fluorodeoxyglucose F-18 FDG, the radiopharmaceutical tracer injected before a PET scan. Maintained by CMS, it describes one study dose up to 45 millicuries and must be reported with a compatible PET CPT code such as 78608, 78811, or 78816. HCPCS code A9552: Description and clinical […]
HCPCS code J9177: Enfortumab vedotin billing guide 2026
HCPCS code J9177 is a Level II HCPCS code that describes Injection, enfortumab vedotin-ejfv, 0.25 mg. CMS established this code effective July 1, 2020, following FDA approval of enfortumab vedotin-ejfv (brand name PADCEV) in 2019. The short descriptor used on claims is “Inj enfort vedo-ejfv 0.25mg.” Because PADCEV is a high-cost oncology drug, using accurate […]
HCPCS code S5000: Prescription drug, generic billing guide
HCPCS Code S5000 is the code for a prescription drug, generic. It belongs to the HCPCS Level II S-code series, which the Centers for Medicare and Medicaid Services (CMS) designates for private payer and Medicaid use in its HCPCS code set. This guide covers the code’s properties, coverage status, documentation requirements, the S5000 vs S5001 […]
HCPCS code Q5123: Billing guide for rituximab-arrx (Riabni)
HCPCS code Q5123: Definition and clinical description HCPCS code Q5123 is the Level II code for injection, rituximab-arrx, biosimilar, (Riabni), 10 mg. It bills by the 10 mg unit, and infusion doses commonly run to 500 mg or 1,000 mg per session. The Centers for Medicare and Medicaid Services (CMS) established the code effective July […]
HCPCS Code A4253: Blood glucose test strips billing guide
HCPCS Code A4253: Definition and clinical description HCPCS Code A4253 covers blood glucose test or reagent strips for a home blood glucose monitor, billed per 50 strips. DMEPOS suppliers and healthcare providers use this code when furnishing single-use strips that patients with diabetes use to measure capillary blood glucose at home. It has been active […]
HCPCS code J3430: Phytonadione billing guide (2026)
HCPCS code J3430 is the billing code for an injection of phytonadione (vitamin K), reported per 1 mg administered. CMS classifies it under the Drugs Administered by Injection category and has designated it a single-dose container code, so every claim needs a JW or JZ modifier. This guide covers the code descriptor, unit billing logic, […]
HCPCS code J0896: Injection, luspatercept-aamt, 0.25 mg
HCPCS code J0896 is the billing code for injection, luspatercept-aamt, 0.25 mg, the brand-name drug Reblozyl used to treat anemia in adults with certain myelodysplastic syndromes and beta-thalassemia. CMS added it to the HCPCS Level II code set effective July 1, 2020, per CMS’s HCPCS program. This guide covers how to calculate billing units, which […]
HCPCS code J7324: Orthovisc billing, units, and reimbursement guide
HCPCS code J7324 is the Level II code for hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose, billed at 1 unit per 30 mg dose. This guide covers billing units, Medicare coverage under LCD L30149, bilateral injection rules, commercial payer variations, and the documentation behind a clean claim. HCPCS code J7324: code description and […]
HCPCS code A0100: Non-emergency transportation; taxi
HCPCS Code A0100 is the HCPCS Level II code for non-emergency transportation by taxi: curb-to-curb trips for ambulatory patients traveling to and from covered medical services. It is billed at a base rate per trip and covered mainly by state Medicaid programs and MCOs, not traditional Medicare. Getting the code, modifiers, and documentation right on […]
HCPCS code J2323: Natalizumab billing guide for infusion clinics
HCPCS code J2323 is the billing code for natalizumab injections, billed per 1 mg unit. It covers Injection, natalizumab, 1 mg, used to report infusions administered for relapsing multiple sclerosis and moderate-to-severe Crohn’s disease. The code applies to both originator Tysabri and its FDA-approved biosimilar, Tyruko, which carries a separate code and separate REMS enrollment. […]