HCPCS |
|---|
| Code | Description |
| A-4221 | Infusion sets and needed supplies |
| C-9399 | Unclassified drugs or biologicals (OPPS Hospitals only) |
| E-0779 | Non-electric syringe pump |
| E-0781 | Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient. (*Medicare reimbursement at E0779 rate for Vivaglobin therapy.) |
| E-0791 | Parenteral infusion pump, stationary, single or multichannel (*Medicare reimbursement at E0779 rate for Vivaglobin therapy.) |
| J-0256 | Injection, alpha1–proteinase inhibitor, human, 10 mg |
| J-0850 | Injection, cytomegalovirus immune globulin intravenous (human), per vial |
| J-1459 | Injection, immune Globulin (Privigen®) per 500 mg - effective 1/1/2009 |
| J-1562 | Injection, immune Globulin (Vivaglobin®), per 100mg |
| J-1566 | Injection, immune globulin, lyophilized, per 500mg |
| J-1680 | Injection, Human fibrinogen concentrate, per 100mg. -effective 1/1/2010 |
| J-2791 | Rhophylac® Injection per 100 IU |
| J-3490 | Unclassified drugs |
| J-3590 | Unclassified biologics |
| J-7187 | Injection, von Willebrand factor complex (Humate P®), per IU VWF:RCO |
| J-7190 | Factor VIII (antihemophilic factor (human)), per IU |
| J-7192 | Factor VIII (antihemophilic factor (recombinant)), per IU |
| J-7193 | Factor IX (antihemophilic factor, purified, non-recombinant) per IU |
| J-7799 | Not otherwise classified drug (other than inhalation drugs) requiring DME for administration |
| K-0552 | Syringe |
| P-9041 | Infusion, albumin (human), 5%, 50 mL |
| P-9045 | Infusion, albumin (human), 5%, 250 mL |
| P-9046 | Infusion, albumin (human), 25%, 20 mL |
| P-9047 | Infusion, albumin (human), 25%, 50 mL |
CPT |
|---|
| Code | Description |
| 96365 | Intravenous infusion for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour |
| 96366 | Each additional hour |
| 96367 | Additional sequential infusion, up to 1 hour |
| 96369 | Subcutaneous infusion for therapy or prophylaxis (specify drug) initial, up to one hour, including pump set-up and establishment of subcutaneous infusion sites |
| 96370 | Subcutaneous infusion - each additional hour (list separately in addition to code for primary procedure) |
| 96371 | Additional pump set up with establishment of new subcutaneous infusion site(s). (List separately in addition to code for primary procedure.)
(Use 96369 and 96371 only once per encounter) |
| 96372 | Therapeutic, prophylactic or diagnostic injection (specify drug or substance); subcutaneous or intramuscular |
| 96374 | Intravenous push, single or initial substance/drug |
| 96375 | Each additional sequential intravenous push of a new substance/drug |
| 96376 | Each additional sequential intravenous push of the same substance/drug provided in a facility |
| 96379 | Unlisted therapeutic prophylactic, or diagnostic intravenous or intra-arterial injection or infusion |
| 96521 | Refilling and maintenance of portable pump |
| 96522 | Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (e.g., intravenous, intra-arterial) (Hospital Outpatient only) |
| 96523 | Irrigation of implanted venous access device for drug delivery systems (Hospital Outpatient only) |
| 99070 | Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided) |
| 99080 | Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form |
ICD-9-CM |
|---|
| Code | Description |
| 287.3 | Idiopathic Thrombocytopenia Purpura |
| 286.0 | Congenital factor VIII disorder |
| 286.1 | Congenital factor IX disorder |
| 286.4 | von Willebrand disease |
| 279.00 | Hypogammaglobulinemia |
| 279.01 | Selective IgA Immunodeficiency |
| 279.02 | Selective IgM Immunodeficiency |
| 279.03 | Other Selective Immunodeficiencies |
| 279.04 | Agammaglobulinemia (X-Linked Bruton's Disease) |
| 279.05 | Immunodeficiency with increased IgM |
| 279.12 | Wiskott-Aldrich Syndrome |
| 279.2 | Severe Combined Immunodeficiency |
| 279.06 | Common Variable Immunodeficiency |
| 273.4 | Alpha-1 antitrypsin Deficiency |
| 277.6 | Angioedema Hereditary |
| 286.3 | Congenital deficiency of other clotting factors |
| 286.9 | Other unspecified coagulation defect |
| 773.0 | Hemolytic Disease due to Rh Isoimmunization |