Question 1

What is HCPCS code J7345?

Accepted Answer

HCPCS code J7345 is "Aminolevulinic acid, 10% gel". Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg

Question 2

What category is J7345 in?

Accepted Answer

J7345 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J7345?

Accepted Answer

Use J7345 when billing for aminolevulinic acid, 10% gel. 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 J7345 covered by Medicare?

Accepted Answer

Coverage for J7345 (Aminolevulinic acid, 10% gel) 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 J7345?

Accepted Answer

Documentation for J7345 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).