Question 1

What is HCPCS code J0881?

Accepted Answer

HCPCS code J0881 is "Darbepoetin alfa, non-esrd". Injection, darbepoetin alfa, 1 microgram (non-esrd use)

Question 2

What category is J0881 in?

Accepted Answer

J0881 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J0881?

Accepted Answer

Use J0881 when billing for darbepoetin alfa, non-esrd. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

What ICD-10 codes are commonly used with J0881?

Accepted Answer

Common ICD-10 diagnosis codes used with J0881 include: B17.10 (Acute hepatitis C without hepatic coma), B17.11 (Acute hepatitis C with hepatic coma), B18.2 (Chronic viral hepatitis C), B19.20 (Unspecified viral hepatitis C without hepatic coma). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is J0881 covered by Medicare?

Accepted Answer

Coverage for J0881 (Darbepoetin alfa, non-esrd) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 6

What documentation is required for J0881?

Accepted Answer

Documentation for J0881 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).