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HCPCS J3420 · Level II · Part B drug

HCPCS J3420: Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J3420

Billing unit
1000 MCG
Vitamin b12 injection
ASP payment limit
$0.648
October 2026; -5.1% vs July 2026
Practitioner MUE
1
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
3 states

TL;DR

HCPCS J3420 is the Level II code for Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg, billed per 1000 MCG. The Medicare Part B ASP payment limit for October 2026 is $0.648 per billing unit, down 5.1% from July 2026. The practitioner MUE allows up to 1 units per date of service (MAI 3). Under OPPS it carries status indicator N. J3420 is billed in units of 1000 MCG; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. The ASP crosswalk maps 39 NDCs to it, sold as Cyanocobalamin by Hikma Pharmaceuticals USA Inc., Henry Schein Inc., American Regent, Inc.. 1 Medicare coverage article lists the code across 3 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J3420 at $0.648 per 1000 MCG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.683 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J3420
QuarterPayment limitPerCoinsurance
October 2026$0.6481000 MCG20%
July 2026$0.6831000 MCG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 39 NDCs from 14 labelers to J3420. Report the NDC in the claim's drug segment and bill the number of J3420 units that equals the quantity administered divided by 1000 MCG; the last column gives units per full package.

NDCs that crosswalk to J3420
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9619-01CyanocobalaminHikma Pharmaceuticals USA Inc.30 × 130
00143-9619-10CyanocobalaminHikma Pharmaceuticals USA Inc.30 × 10300
00143-9620-10CyanocobalaminHikma Pharmaceuticals USA Inc.10 × 10100
00143-9621-25CyanocobalaminHikma Pharmaceuticals USA Inc.1 × 2525
00404-9783-30CyanocobalaminHenry Schein Inc.30 × 130
00404-9786-10CyanocobalaminHenry Schein Inc.10 × 110
00404-9840-10CyanocobalaminHenry Schein Inc.10 × 110
00404-9995-30CyanocobalaminHenry Schein Inc.30 × 130
00517-0031-25CyanocobalaminAmerican Regent, Inc.1 × 2525
00517-0032-25CyanocobalaminAmerican Regent, Inc.10 × 25250
00517-0130-01CyanocobalaminAmerican Regent, Inc.30 × 130
25021-0502-01CyanocobalaminSagent Pharmaceuticals1 × 2525
50090-2709-00CyanocobalaminA-S Medication Solutions1 × 2525
50090-6229-00CyanocobalaminA-S Medication Solutions1 × 2525
51662-1394-01CyanocobalaminHF Acquisition Co. LLC, DBA HealthFirst30 × 130
51662-1647-03CyanocobalaminHF Acquisition Co. LLC, DBA HealthFirst1 × 2525
63323-0044-01CyanocobalaminFreseniUS Kabi USA, LLC1 × 2525
63323-0044-44CyanocobalaminFreseniUS Kabi USA, LLC1 × 2525
68001-0542-60CyanocobalaminBluePoint Laboratories1 × 2525
68001-0640-60CyanocobalaminBluePoint Laboratories1 × 2525
69680-0112-10CyanocobalaminVitruvias Therapeutics, Inc.1 × 1010
69680-0112-25CyanocobalaminVitruvias Therapeutics, Inc.1 × 2525
69680-0113-99CyanocobalaminVitruvias Therapeutics, Inc.10 × 10100
69680-0121-05CyanocobalaminVitruvias Therapeutics, Inc.30 × 5150
70069-0005-10CyanocobalaminSomerset Pharma, LLC1 × 2525
70069-0171-10CyanocobalaminSomerset Pharma, LLC30 × 10300
70069-0172-10CyanocobalaminSomerset Pharma, LLC10 × 10100
70710-1663-07CyanocobalaminZydus Pharmaceuticals (USA) Inc.1 × 2525
70710-1664-06CyanocobalaminZydus Pharmaceuticals (USA) Inc.10 × 10100
70710-1664-07CyanocobalaminZydus Pharmaceuticals (USA) Inc.10 × 25250
70710-1665-01CyanocobalaminZydus Pharmaceuticals (USA) Inc.30 × 130
70710-1665-05CyanocobalaminZydus Pharmaceuticals (USA) Inc.30 × 5150
70756-0635-25CyanocobalaminLifestar Pharma1 × 2525
71288-0300-02CyanocobalaminMeitheal Pharmaceuticals Inc.1 × 2525
71288-0301-11CyanocobalaminMeitheal Pharmaceuticals Inc.10 × 10100
71288-0302-30CyanocobalaminMeitheal Pharmaceuticals Inc.30 × 130
71288-0303-02CyanocobalaminMeitheal Pharmaceuticals Inc.1 × 2525
71288-0303-92CyanocobalaminMeitheal Pharmaceuticals Inc.1 × 2525
72603-0650-25CyanocobalaminNorthstar RxLLC1 × 2525

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J3420. For practitioners the limit is 1 unit per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J3420 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital13 Date of Service Edit: ClinicalPrescribing Information
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J3420 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J3420 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists J3420 in their HCPCS tables, covering 3 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing J3420
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Vitamin B<sub>12</sub> InjectionsFirst Coast Service Options, Inc.FL PR VIL33967

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J3420 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J3420 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J3420 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J3420

What does HCPCS code J3420 describe?

J3420 is defined by CMS as "Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg". Each billing unit represents 1000 MCG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J3420 in October 2026?

The ASP-based payment limit is $0.648 per 1000 MCG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.683.

How many units of J3420 can be billed per day?

The practitioner Medically Unlikely Edit is 1 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Prescribing Information" as the rationale.

Which NDCs map to J3420?

The October 2026 ASP crosswalk lists 39 NDCs from 14 labelers: Cyanocobalamin (Hikma Pharmaceuticals USA Inc.); Cyanocobalamin (Henry Schein Inc.); Cyanocobalamin (American Regent, Inc.); Cyanocobalamin (Sagent Pharmaceuticals). For example NDC 00143-9619-01 is a 30 package equal to 30 billing units. The crosswalk's billing-units-per-package figure converts each package into J3420 units.

Does J3420 have NCCI bundling edits?

No active practitioner PTP pairs list J3420 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention J3420?

1 current Billing and Coding Article in the Medicare Coverage Database list J3420, covering 3 states: (Billing and Coding: Vitamin B<sub>12</sub> Injections).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.