Medicare maximum allowable unit for Drug - Biological CPTs

Drugs & Biologicals: Maximum Allowed Units (MAUs) - Palmetto GBA Medicare

cpt code and description

J1040 - Injection, methylprednisolone acetate, 80 mg
J1170 - Injection, hydromorphone, up to 4 mg

Maximum Allowed Units List

KEY	HCPCS Code	Code Description	MAU	Release Date	Reassesment Date
	J0129	Injection, abatacept, 10 mg	100	10/16/2008
	J0150	Injection, adenosine for therapeutic use, 6 mg	5	10/16/2008	7/1/2010
	J0152	Injection, adenosine for diagnostic use, 30 mg	4	10/16/2008
	J0170	Injection, adrenalin, epinephrine, up to 1 ml ampul	2	10/16/2008
	J0180	Injection, agalsidase beta, 1 mg	105	10/16/2008
	J0207	Injection, amifostine, 500 mg	5	10/16/2008
	J0215	Injection, alefacept, 0.5 mg	30	10/16/2008
5	J0256	Injection, alpha 1-proteinase inhibitor-human, 10 mg	3,000	10/16/2008	4/10/2009
	J0270	Injection, alprostadil, 1.25 mcg	1	10/16/2008
	J0275	Alprostadil urethral suppository	1	10/16/2008
	J0278	Injection, amikacin sulfate, 100 mg	6	10/16/2008
	J0280	Injection, aminophylline, up to 250 mg	1	10/16/2008
	J0282	Injection, amiodarone hydrochloride, 30 mg	20	10/16/2008
	J0285	Injection, amphotericin B, 50 mg	1	10/16/2008
	J0288	Injection, amphotericin B cholesteryl sulfate complex, 10 mg	45	7/17/2009
	J0289	Injection, amphotericin B liposome, 10 mg	30	10/16/2008
	J0290	Injection, ampicillin sodium, 500 mg	4	10/16/2008
	J0295	Injection, ampicillin sodium/sulbactam sodium, per 1.5 gram	4	10/16/2008
	J0360	Injection, hydralazine HCl, up to 20 mg	1	10/16/2008
	J0390	Injection, chloroquine HCl, up to 250 mg	4	10/16/2008
	J0456	Injection, azithromycin, 500 mg	1	10/16/2008
9	J0460	Injection, atropine sulfate, up to 0.3 mg	4	10/16/2008
	J0461	Injection, atropine sulfate, up to 0.01 mg	120	1/1/2010
5	J0475	Injection, baclofen, 10 mg	8	10/16/2008
	J0476	Injection, baclofen, 50 mcg for intrathecal trial	2	10/16/2008
	J0500	Injection, dicyclomine HCl, up to 20 mg	1	10/16/2008
	J0515	Injection, benztropine mesylate, per 1 mg	2	10/16/2008
9	J0530	Injection, penicillin G benzathine and penicillin G procaine, up to 600,000 units	2	10/16/2008
9	J0540	Injection, penicillin G benzathine and penicillin G procaine, up to 1,200,000 units	2	10/16/2008
9	J0550	Injection, penicillin G benzathine and penicillin G procaine, up to 2,400,000 units	1	10/16/2008
	J0559	Injection, penicillin G benzathine and penicillin G procaine, 2500 units	960	1/1/2010
	J0560	Injection, penicillin G benzathine, up to 600,000 units	4	10/16/2008	7/1/2010
	J0570	Injection, penicillin G benzathine, up to 1,200,000 units	2	10/16/2008
	J0580	Injection, penicillin G benzathine, up to 2,400,000 units	1	10/16/2008
	J0583	Injection, bivalirudin, 1 mg	250	10/16/2008	7/1/2010
	J0585	Botulinum toxin type A, per unit	600	11/18/2008	12/31/2008
	J0586	Injection, abobotulinumtoxina, 5 units	200	1/1/2010
	J0587	Botulinum toxin type B, per 100 units	250	10/16/2008	6/1/2010
	J0592	Injection, buprenorphine hydrochloride, 0.1mg	3	10/16/2008
	J0595	Injection, butorphanol tartrate, 1 mg	4	10/16/2008
	J0598	Injection, C1 esterase inhibitor (human), 10 units	100	1/1/2010
	J0600	Injection, edetate calcium disodium, up to 1000 mg	3	10/16/2008	7/1/2010
	J0610	Injection, calcium gluconate, per 10 ml	2	10/16/2008
	J0637	Injection, caspofungin acetate, 5 mg	14	10/16/2008
	J0640	Injection, leucovorin calcium, per 50 mg	24	10/16/2008
8	J0641	Injection, levoleucovorin calcium, 0.5 mg	200	12/16/2008
	J0670	Injection, mepivacaine HCl, per 10 ml	4	10/16/2008
	J0690	Injection, cefazolin sodium, 500 mg	12	10/16/2008	6/1/2010
	J0692	Injection, cefepime hydrochloride, 500 mg	8	10/16/2008
	J0694	Injection, cefoxitin sodium, 1 gram	8	10/16/2008
	J0696	Injection, ceftriaxone sodium, per 250 mg	16	10/16/2008
	J0697	Injection, sterile cefuroxime sodium, per 750 mg	4	10/16/2008
	J0698	Injection, cefotaxime sodium, per gm	6	10/16/2008
	J0702	Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate, per 3 mg	4	10/16/2008	Denied
	J0704	Injection, betamethasone sodium phosphate, per 4 mg	5	10/16/2008
	J0713	Injection, ceftazidime, per 500 mg	12	10/16/2008	6/1/2010
	J0715	Injection, ceftizoxime sodium, per 500 mg	8	11/7/2008
	J0718	Injection, certolizumab pegol, 1 mg	400	1/1/2010	Removed: self administered drug list
	J0720	Injection, chloramphenicol sodium succinate, up to 1 gm	6	11/7/2008
5	J0735	Injection, clonidine hydrochloride, 1 mg	2	11/7/2008	7/1/2010
	J0743	Injection, cilastatin sodium; imipenem, per 250 mg	8	11/7/2008
	J0744	Injection, ciprofloxacin for intravenous infusion, 200 mg	6	11/7/2008
	J0780	Injection, prochlorperazine, up to 10 mg	4	11/7/2008
	J0800	Injection, corticotropin, up to 40 units	2	11/7/2008
	J0833	Injection, cosyntropin, not otherwise specified, 0.25 mg	3	1/1/2010
	J0834	Injection, cosyntropin, (cortrosyn), 0.25 mg	3	1/1/2010
9	J0835	Injection, cosyntropin, per 0.25 mg	1	11/7/2008
	J0878	Injection, daptomycin, 1 mg	1000	11/7/2008
	J0881	Injection, darbepoetin alfa, 1 microgram (non-ESRD use)	500	12/16/2008
	J0882	Injection, darbepoetin alfa, 1 microgram (for ESRD on dialysis)	400	12/16/2008	7/1/2009
	J0885	Injection, epoetin alfa, (for non-ESRD use), 1000 units	60	12/16/2008
	J0886	Injection, epoetin alfa, 1000 units (for ESRD on dialysis)	45	12/16/2008
	J0894	Injection, decitabine, 1 mg	100	11/7/2008
	J0895	Injection, deferoxamine mesylate, 500 mg	6	11/7/2008
	J0900	Injection, testosterone enanthate and estradiol valerate, up to 1 cc	1	11/7/2008	4/1/2010
	J0945	Injection, brompheniramine maleate, per 10 mg	2	11/7/2008
	J0970	Injection, estradiol valerate, up to 40 mg	1	11/7/2008
	J1000	Injection, depo-estradiol cypionate, up to 5 mg	1	11/7/2008
	J1020	Injection, methylprednisolone acetate, 20 mg	6	11/7/2008
	J1030	Injection, methylprednisolone acetate, 40 mg	4	11/7/2008
	J1040	Injection, methylprednisolone acetate, 80 mg	3	11/7/2008
	J1051	Injection, medroxyprogesterone acetate, 50 mg	8	11/7/2008
2	J1055	Injection, medroxyprogesterone acetate for contraceptive use, 150 mg	0	11/7/2008
	J1060	Injection, testosterone cypionate and estradiol cypionate, up to 1 ml	1	11/7/2008	4/1/2010
	J1070	Injection, testosterone cypionate, up to 100 mg	4	11/7/2008
	J1080	Injection, testosterone cypionate, 1 cc, 200 mg	2	11/7/2008
	J1094	Injection, dexamethasone acetate, 1 mg	16	11/7/2008
	J1100	Injection, dexamethasone sodium phosphate, 1 mg	110	11/7/2008
	J1110	Injection, dihydroergotamine mesylate, per 1 mg	3	11/7/2008
	J1120	Injection, acetazolamide sodium, up to 500 mg	2	11/7/2008
	J1160	Injection, digoxin, up to 0.5 mg	2	11/7/2008
	J1162	Injection, digoxin immune fab (ovine), per vial	6	11/7/2008	7/1/2010
	J1165	Injection, phenytoin sodium, per 50 mg	35	11/7/2008
5	J1170	Injection, hydromorphone, up to 4 mg	300	11/7/2008
	J1180	Injection, dyphylline, up to 500 mg	1	11/7/2008
	J1190	Injection, dexrazoxane hydrochloride, per 250 mg	5	11/7/2008
	J1200	Injection, diphenhydramine HCl, up to 50 mg	8	11/7/2008
	J1205	Injection, chlorothiazide sodium, per 500 mg	4	11/7/2008
	J1212	Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml	1	11/7/2008
5	J1230	Injection, methadone HCl, up to 10 mg	10	11/7/2008
	J1240	Injection, dimenhydrinate, up to 50 mg	1	11/7/2008
	J1245	Injection, dipyridamole, per 10 mg	6	11/7/2008
	J1250	Injection, dobutamine hydrochloride, per 250 mg	2	7/17/2009
	J1260	Injection, dolasetron mesylate, 10 mg	20	7/17/2009
8	J1267	Injection, doripenem, 10 mg	100	12/16/2008
	J1300	Injection, eculizumab, 10 mg	90	7/17/2009
	J1325	Injection, epoprostenol, 0.5 mg	1	12/16/2008	7/1/2010
	J1327	Injection, eptifibatide, 5 mg	4	12/16/2008
4	J1330	Injection, ergonovine maleate, up to 0.2 mg	0	11/21/2008
	J1335	Injection, ertapenem sodium, 500 mg	2	11/14/2008
	J1364	Injection, erythromycin lactobionate, per 500 mg	5	12/16/2008
	J1380	Injection, estradiol valerate, up to 10 mg	3	11/14/2008
	J1390	Injection, estradiol valerate, up to 20 mg	2	11/14/2008
	J1410	Injection, estrogen conjugated, per 25 mg	2	12/16/2008
	J1435	Injection, estrone, per 1 mg	1	12/16/2008	7/1/2010
	J1440	Injection, filgrastim (G-CSF), 300 mcg	4	12/3/2008
	J1441	Injection, filgrastim (G-CSF), 480 mcg	3	11/7/2008
	J1450	Injection, fluconazole, 200 mg	6	11/14/2008
8	J1453	Injection, fosaprepitant, 1 mg	115	12/16/2008
8	J1459	Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g. liquid), 500 mg	220	12/16/2008
	J1460	Injection, gamma globulin, intramuscular, 1cc	1	4/1/2010
	J1470	Injection, gamma globulin; intramuscular, 2 cc	1	11/14/2008
	J1480	Injection, gamma globulin, intramuscular, 3 cc	1	4/1/2010
	J1490	Injection, gamma globulin, intramuscular, 4 cc	1	4/1/2010
	J1500	Injection, gamma globulin, intramuscular, 5 cc	1	4/1/2010
	J1510	Injection, gamma globulin, intramuscular, 6 cc	1	4/1/2010
	J1520	Injection, gamma globulin; intramuscular, 7 cc (gama stan ds)	1	7/17/2009	4/1/2010
	J1530	Injection, gamma globulin, intramuscular, 8 cc	1	4/1/2010
	J1540	Injection, gamma globulin, intramuscular, 9 cc	1	4/1/2010
	J1550	Injection, gamma globulin; intramuscular, 10 cc	1	11/14/2008	4/1/2010
	J1560	Injection, gamma globulin, intramuscular, over 10 cc	1	4/1/2010
	J1561	Injection, immune globulin, (gamunex), intravenous, non-lyophilized (e.g., liquid), 500 mg	440	7/17/2009
	J1562	Injection, immune globulin, (vivaglobin), 100 mg	220	7/17/2009
	J1566	Injection, immune globulin, intravenous, lyophilized (e.g. powder), not otherwise specified, 500 mg	440	12/16/2008
	J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized, (e.g., liquid), 500 mg	440	7/17/2009	12/28/2009
	J1569	Injection, immune globulin, (gammagard liquid), intravenous, non-lyophilized, (e.g., liquid), 500 mg	440	7/17/2009	12/28/2009
	J1570	Injection, ganciclovir sodium, 500 mg	2	7/17/2009
	J1580	Injection, garamycin, gentamicin, up to 80 mg	5	12/16/2008
4	J1590	Injection, gatifloxacin, 10 mg	0	11/14/2008
	J1600	Injection, gold sodium thiomalate, up to 50 mg	1	11/14/2008
	J1610	Injection, glucagon hydrochloride, per 1 mg	1	11/14/2008
	J1626	Injection, granisetron hydrochloride, 100 mcg	11	12/3/2008
	J1630	Injection, haloperidol, up to 5 mg	5	11/14/2008	7/1/2010
	J1631	Injection, haloperidol decanoate, per 50 mg	2	11/14/2008
	J1640	Injection, hemin, 1 mg	660	12/3/2008
	J1642	Injection, heparin sodium, (heparin lock flush), per 10 units	4	11/14/2008
	J1644	Injection, heparin sodium, per 1,000 units	40	11/14/2008
	J1645	Injection, dalteparin sodium, per 2500 IU	9	12/3/2008
	J1650	Injection, enoxaparin sodium, 10 mg	17	12/3/2008	2/27/2009
	J1652	Injection, fondaparinux sodium, 0.5 mg	20	11/14/2008
	J1655	Injection, tinzaparin sodium, 1000 IU	28	12/16/2008
	J1670	Injection, tetanus immune globulin, human, up to 250 units	1	11/14/2008
5	J1680	Injection, human fibrinogen concentrate, 100 mg	78	1/1/2010
4	J1710	Injection, hydrocortisone sodium phosphate, up to 50 mg	0	11/21/2008
	J1720	Injection, hydrocortisone sodium succinate, up to 100 mg	110	12/16/2008
	J1740	Injection, ibandronate sodium, 1 mg	3	7/17/2009
	J1743	Injection, idursulfase, 1 mg	55	7/17/2009
	J1745	Injection, infliximab, 10 mg	110	11/14/2008	12/2/2008
8	J1750	Injection, iron dextran, 50 mg	90	12/16/2008
7	J1751	Injection, iron dextran 165, 50 mg	90	12/16/2008
7	J1752	Injection, iron dextran 267, 50 mg	90	12/16/2008
	J1756	Injection, iron sucrose, 1 mg	500	12/3/2008	5/1/2009
5	J1785	Injection, imiglucerase, per unit	6600	12/16/2008
	J1790	Injection, droperidol, up to 5 mg	2	11/14/2008	7/1/2010
	J1800	Injection, propranolol HCl, up to 1 mg	6	12/16/2008
3	J1815	Injection, insulin, per 5 units	0	11/14/2008
	J1817	Insulin for administration through DME (i.e., Insulin pump) per 50 units	5	12/16/2008
	J1840	Injection, kanamycin sulfate, up to 500 mg	2	7/17/2009
	J1850	Injection, kanamycin sulfate, up to 75 mg	4	7/1/2010
	J1885	Injection, ketorolac tromethamine, per 15 mg	8	11/14/2008
8	J1930	Injection, lanreotide, 1 mg	120	12/16/2008
	J1940	Injection, furosemide, up to 20 mg	8	12/3/2008	6/1/2010
	J1950	Injection, leuprolide acetate (for depot suspension), per 3.75 mg	1	12/3/2008
8	J1953	Injection, levetiracetam, 10 mg	150	12/16/2008
	J1956	Injection, levofloxacin, 250 mg	3	11/14/2008

Guideline


Q: We are a solo practice looking for alternate sources of revenue. A semi-retired anesthesiologist has expressed interest in coming into our office weekly to do lumbar epidural steroid injections (ESIs). This seems like a good move for us since we refer out about 10 patients a week for these procedures. He will be performing only straightforward lumbar ESIs. How would we code for his services?

A: For the lumbar ESI itself you would bill CPT 62311, injection, single (not via indwelling catheter), not including neurolytic substance, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal). Depo-medrol comes in 20mg (J1020), 30mg (J1030), and 80 mg (J1040) vials. Other supplies used are generally included in the RVUs for the procedure and not billed separately.