Table of content for "Injection, bezlotoxumab" (HCPCS C9490)
General information on the “C9490” code
HCPCS Code: C9490
Long Description: Injection, bezlotoxumab, 10 mg
Short Description: Injection, bezlotoxumab
Original information is taken from C9490 page
Pricing indicators
Pricing Indicator Code 1: 53 – Statute
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Statute Number: 1833(t)
Cross Reference Code 1: J0565 ;
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 9 – Other medical items or services
Type Of Service 2: F – Ambulatory surgical center (facility usage for surgical services)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20170701
Code Effective Date: 20180101
Termination Date: 20171231
Action Code: N – No maintenance for this code