J code lookup by drug name

A J code is a HCPCS Level II code whose first character is J. CMS uses the J range mainly for drugs administered other than by mouth, such as injections and infusions given in a physician office or hospital outpatient department, along with some chemotherapy and immunosuppressive drugs. Most codes name one drug at a stated billing unit, for example 10 mg; a few, such as the unclassified-drug codes, are catch-alls.

A drug can need several codes when it comes in different formulations, routes or strengths of billing unit, when a co-formulated product (for example with hyaluronidase) is billed separately, or when CMS gives a biosimilar or a specific manufacturer's product its own code. 170 names in this index map to more than one code; immune globulin has the most, with 16.

Match the descriptor to the product actually given: the generic name, any formulation or brand in parentheses, and the billing unit. Then report units as the dose given divided by the code's billing unit, and add the NDC from the package. Each code page lists the NDCs CMS crosswalks to it, with billing units per package.

Brand names come from the drug-name column of the CMS ASP NDC-HCPCS crosswalk, which lists the marketed products whose NDCs bill under each code; generic names come from the HCPCS Level II descriptor. A brand family row (for example Darzalex) gathers the brand names that share a first word.