Table of content for "Phenytoin sodium injection" (HCPCS J1165)
General information on the “J1165” code
HCPCS Code: J1165
Long Description: Injection, phenytoin sodium, per 50 mg
Short Description: Phenytoin sodium injection
Original information is taken from J1165 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: 19820101
Code Effective Date: 19970101
Action Code: N – No maintenance for this code