Table of content for "Intraocular fomivirsen na" (HCPCS J1452)
General information on the “J1452” code
HCPCS Code: J1452
Long Description: Injection, fomivirsen sodium, intraocular, 1.65 mg
Short Description: Intraocular fomivirsen na
Original information is taken from J1452 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: 20010101
Code Effective Date: 20140101
Action Code: N – No maintenance for this code