Table of content for "Ampicillin sulbactam 1.5 gm" (HCPCS J0295)
General information on the “J0295” code
HCPCS Code: J0295
Long Description: Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
Short Description: Ampicillin sulbactam 1.5 gm
Original information is taken from J0295 page
Pricing indicators
Pricing Indicator Code 1: 51 – Drugs
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 1 – Medical care
Type Of Service 2: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19950101
Code Effective Date: 20190101
Action Code: N – No maintenance for this code