HCPCS J1055 Code. Medrxyprogester acetate inj

HCPCS Code: J1055
Long Description: Injection, medroxyprogesterone acetate for contraceptive use, 150 mg
Short Description: Medrxyprogester acetate inj

Original information is taken from J1055 page

Pricing Indicator Code 1: 00 – Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator Code 9 : Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')

Statute Number: 1862A1

Coverage: S – Non-covered by Medicare statute

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

Anesthesia Base Unit Quantity: 0
Code Added Date: 19940101
Code Effective Date: 20130101
Termination Date: 20121231
Action Code: N – No maintenance for this code