Last Modified: 12/5/2018 Location: FL, PR, USVI Business: Part B
Billing unlisted drug procedure codes J3490 and J9999
Procedure codes J3490 and J9999 are unlisted codes for injection services.
• J3490 - Unclassified drugs
• J9999 - Not otherwise classified, antineoplastic drugs
When billing for these codes, the provider must indicate the name, strength, and dosage of the drug in block 19 on the CMS-1500 claim form (or in 2400.SV101-7 in the ANSI 837 claim file).
Pricing information for most unlisted drugs may be found on the Centers for Medicare & Medicaid Services (CMS) website at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index.html .
For local coverage determinations (LCDs) pertaining to an unlisted drug, refer to the LCD lookup tool. Please note, however, that most unlisted drugs are not covered by an LCD.
Source: CMS IOM Pub 100-04, Ch. 17
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