Question 1

What is HCPCS code J1442?

Accepted Answer

HCPCS code J1442 is "Inj filgrastim excl biosimil". Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram

Question 2

What category is J1442 in?

Accepted Answer

J1442 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J1442?

Accepted Answer

Use J1442 when billing for inj filgrastim excl biosimil. 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 J1442?

Accepted Answer

Common ICD-10 diagnosis codes used with J1442 include: B20 (Human immunodeficiency virus [HIV] disease), C00.0 (Malignant neoplasm of external upper lip), C00.1 (Malignant neoplasm of external lower lip), C00.2 (Malignant neoplasm of external lip, unspecified). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is J1442 covered by Medicare?

Accepted Answer

Coverage for J1442 (Inj filgrastim excl biosimil) 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 J1442?

Accepted Answer

Documentation for J1442 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).