Question 1

What is HCPCS code J1559?

Accepted Answer

HCPCS code J1559 is "Hizentra injection". Injection, immune globulin (hizentra), 100 mg

Question 2

What category is J1559 in?

Accepted Answer

J1559 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J1559?

Accepted Answer

Use J1559 when billing for hizentra injection. 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 J1559?

Accepted Answer

Common ICD-10 diagnosis codes used with J1559 include: C90.00 (Multiple myeloma not having achieved remission), C90.02 (Multiple myeloma in relapse), C91.10 (Chronic lymphocytic leukemia of B-cell type not having achieved remission), C91.12 (Chronic lymphocytic leukemia of B-cell type in relapse). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is J1559 covered by Medicare?

Accepted Answer

Coverage for J1559 (Hizentra injection) 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 J1559?

Accepted Answer

Documentation for J1559 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).