Key facts for J7699
- Medicare payment
- no PFS amount
- PFS status E
- Coverage code
- D
- special coverage instructions apply
- Practitioner MUE
- 1
- MAI 3
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 1 / 0
TL;DR
CMS describes HCPCS J7699, added in 1993, as "Noc drugs, inhalation solution administered through dme". The physician fee schedule lists J7699 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it. Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 0 (MAI 3, CMS Policy). 1 active LCD lists J7699: L33370 (Nebulizers). OPPS status indicator M: Service not billable to the FI/MAC. HCPCS record: BETOS D1G (drugs administered through DME); pricing indicator 51; type of service 1 (medical care), P (lump-sum purchase of DME, prosthetics or orthotics). 1 other active code opens with "Noc drugs"; related codes: J7799, J7999, J7298, J7297.
J7699 descriptor and code status
The October 2026 HCPCS Level II file describes J7699 as “Noc drugs, inhalation solution administered through dme”. It sits in the J section (drugs administered other than oral method and chemotherapy drugs), listed with the other J codes without an ASP payment limit.
| Field | Value |
|---|---|
| Short descriptor | Inhalation solution for dme |
| Added to HCPCS | 1993-01-01 |
| Last action | N (no maintenance), effective 2007-01-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 51: drugs |
| BETOS category | D1G: drugs administered through DME |
| Type of service | 1: medical care; P: lump-sum purchase of DME, prosthetics or orthotics |
Medicare payment for J7699
The physician fee schedule lists J7699 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.
Physician fee schedule (RVU26D)
Status E: excluded from the physician fee schedule by regulation. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).
Hospital outpatient (OPPS Addendum B)
Status indicator M (Service not billable to the FI/MAC), with no separate OPPS payment rate.
Medically Unlikely Edits for J7699
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 0 (MAI 3, CMS Policy). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
| Facility outpatient hospital | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
The MUE lookup for J7699 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists J7699 in v323r0.
J7699 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.
Pair counts show exposure, not the answer for one claim. Check J7699 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for J7699
1 active Local Coverage Determination and 0 billing and coding articles list J7699. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Nebulizers (L33370) · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
Denials to expect on J7699
the diagnosis or documentation does not meet the LCD or billing article that lists J7699
the modifier reported is inconsistent with the code
the claim lacks the description, invoice or pricing detail a contractor-priced code needs
Where QuickIntell fits for J7699 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for J7699 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS J7699
What does HCPCS code J7699 describe?
"Noc drugs, inhalation solution administered through dme" (short descriptor "Inhalation solution for dme"), in the J section (drugs administered other than oral method and chemotherapy drugs). Added 1993-01-01; last action N (no maintenance) effective 2007-01-01.
Is J7699 a CPT code?
No. J7699 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for J7699?
The physician fee schedule lists J7699 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it.
How many units of J7699 can be billed per day?
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 0 (MAI 3, CMS Policy). For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover J7699?
Coverage code D (special coverage instructions apply). 1 active LCD lists J7699: L33370 (Nebulizers).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
Disclaimer
This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.