Question 1

What is HCPCS code J1642?

Accepted Answer

HCPCS code J1642 is "Inj heparin sodium per 10 u". Injection, heparin sodium, (heparin lock flush), per 10 units

Question 2

What category is J1642 in?

Accepted Answer

J1642 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J1642?

Accepted Answer

Use J1642 when billing for inj heparin sodium per 10 u. 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

Is J1642 covered by Medicare?

Accepted Answer

Coverage for J1642 (Inj heparin sodium per 10 u) 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 5

What documentation is required for J1642?

Accepted Answer

Documentation for J1642 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).