Question 1

What is HCPCS code J1573?

Accepted Answer

HCPCS code J1573 is "Hepagam b intravenous, inj". Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml

Question 2

What category is J1573 in?

Accepted Answer

J1573 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J1573?

Accepted Answer

Use J1573 when billing for hepagam b intravenous, inj. 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 J1573?

Accepted Answer

Common ICD-10 diagnosis codes used with J1573 include: B16.1 (Acute hepatitis B with delta-agent without hepatic coma), B16.2 (Acute hepatitis B without delta-agent with hepatic coma), B16.9 (Acute hepatitis B without delta-agent and without hepatic coma), B17.0 (Acute delta-(super) infection of hepatitis B carrier). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is J1573 covered by Medicare?

Accepted Answer

Coverage for J1573 (Hepagam b intravenous, inj) 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 J1573?

Accepted Answer

Documentation for J1573 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).