Table of content for "Fomepizole, 15 mg" (HCPCS J1451)
General information on the “J1451” code
HCPCS Code: J1451
Long Description: Injection, fomepizole, 15 mg
Short Description: Fomepizole, 15 mg
Original information is taken from J1451 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
ASC Payment Group: YY
ASC Payment Group Effective Date: 20080101
Type of service
Processing Note Number: 0095
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: 20060101
Code Effective Date: 20060101
Action Code: N – No maintenance for this code