Question 1

What is HCPCS code J8610?

Accepted Answer

HCPCS code J8610 is "Methotrexate oral 2.5 mg". Methotrexate; oral, 2.5 mg

Question 2

What category is J8610 in?

Accepted Answer

J8610 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J8610?

Accepted Answer

Use J8610 when billing for methotrexate oral 2.5 mg. 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 J8610 covered by Medicare?

Accepted Answer

Coverage for J8610 (Methotrexate oral 2.5 mg) 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 J8610?

Accepted Answer

Documentation for J8610 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).