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Last Modified: 10/23/2024 Location: FL, PR, USVI Business: Part A, Part B

Drug HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor-priced HCPCS codes no longer require a paper invoice.
When the invoice information is entered in the narrative field on a claim for any of the HCPCS codes listed below, it is not necessary to provide the actual paper invoice for these services. For details, view our article on the process for supplying invoice amount on certain HCPCS codes to avoid rejected claims.

Code
Description
Effective "from"
date of service
Effective "through"
date of service
J0209
Injection, sodium thiosulfate (hope), 100 mg
4/1/2024
Present
J0211
Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)
7/1/2024
Present
J0220
Injection, alglucosidase alfa, 10 mg, not otherwise specified
1/1/2024
Present
J0380
Injection, metaraminol bitartrate, per 10 mg
1/1/2024
Present
J0390
Injection, chloroquine HCl, up to 250 mg
1/1/2024
Present
J0400
Injection, aripiprazole, intramuscular, 0.25 mg
1/1/2024
Present
J0571
Buprenorphine, oral, 1 mg
1/1/2024
Present
J0572
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
1/1/2024
Present
J0573
Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine
1/1/2024
Present
J0574
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine
1/1/2024
Present
J0575
Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine
1/1/2024
Present
J0600
Edtate calcium disodium, up to 1000 mg
1/1/2024
Present
J0620
Injection, calcium glycerophosphate and calcium lactate, per 10 ml
1/1/2024
Present
J0650
Injection, levothyroxine sodium, not otherwise specified, 10 mcg
4/1/2024
Present
J0716
Injection, Centruroides immune f(ab)2, up to 120 mg
1/1/2024
Present
J1180
Injection, dyphylline, up to 500 mg
1/1/2024
Present
J1434
Injection, fosaprepitant (focinvez), 1 mg
4/1/2024
Present
J1436
Injection, etidronate disodium, per 300 mg
1/1/2024
Present
J1562
Injection, immune globulin (Vivaglobin), 100 mg
1/1/2024
Present
J1598
Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to J1596, 0.1 mg
7/1/2024
9/30/2024
J1599
Injection, immune globulin, intravenous, nonlyophilized (e.g., liquid), not otherwise specified, 500 mg
1/1/2024
Present
J1600
Injection, gold sodium thiomalate, up to 50 mg
1/1/2024
Present
J1675
Injection, histrelin acetate, 10 mcg
1/1/2024
Present
J1710
Injection, hydrocortisone sodium phosphate, up to 50 mg
1/1/2024
Present
J1729
Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
1/1/2024
Present
J1749
Injection, iloprost, 0.1 mcg
10/1/2024
Present
J1810
Injection, droperidol and fentanyl citrate, up to 2 ml ampule
1/1/2024
Present
J1840
Injection, kanamycin sulfate, up to 500 mg
1/1/2024
Present
J1850
Injection, kanamycin sulfate, up to 75 mg
1/1/2024
Present
J1890
Injection, cephalothin sodium, up to 1 g
1/1/2024
Present
J1990
Injection, chlordiazepoxide HCl, up to 100 mg
1/1/2024
Present
J2003
Injection, lidocaine hydrochloride, 1 mg
10/1/2024
Present
J2004
Injection, lidocaine hcl with epinephrine, 1 mg
10/1/2024
Present
J2180
Injection, meperidine and promethazine HCl, up to 50 mg
1/1/2024
Present
J2252
Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
10/1/2024
Present
J2253
Injection, midazolam (seizalam), 1 mg
10/1/2024
Present
J2355
Injection, oprelvekin, 5 mg
1/1/2024
Present
J2400
Injection, chloroprocaine HCl, per 30 ml
1/1/2024
Present
J2410
Injection, oxymorphone HCl, up to 1 mg
1/1/2024
Present
J2468
Injection, palonosetron hydrochloride (avyxa), not therapeutically equivalent to J2469, 25 micrograms
7/1/2024
Present
J2504
Injection, pegademase bovine, 25 IU
1/1/2024
Present
J2513
Injection, pentastarch, 10% solution, 100 ml
1/1/2024
Present
J2650
Injection, prednisolone acetate, up to 1 ml
1/1/2024
Present
J2670
Injection, tolazoline HCl, up to 25 mg
1/1/2024
Present
J2725
Injection, protirelin, per 250 mcg
1/1/2024
Present
J2730
Injection, pralidoxime chloride, up to 1 g
1/1/2024
Present
J2770
Injection quinupristin/dalfopristin 500mg/(150/3520)
1/1/2024
Present
J2780
Injection, ranitidine HCl, 25 mg
1/1/2024
Present
J2797
Injection, rolapitant, 0.5 mg
1/1/2024
Present
J2810
Injection, theophylline, per 40 mg
1/1/2024
Present
J2993
Injection, reteplase, 18.1 mg
1/1/2024
Present
J3265
Injection, torsemide, 10 mg/ml
1/1/2024
Present
J3302
Injection, triamcinolone diacetate, per 5 mg
1/1/2024
Present
J3303
Injection, triamcinolone hexacetonide, per 5 mg
1/1/2024
Present
J3310
Injection, perphenazine, up to 5 mg
1/1/2024
Present
J3316
Injection, triptorelin, extended-release, 3.75 mg
1/1/2024
Present
J3350
injection, urea, up to 40 g
1/1/2024
Present
J3355
Injection, urofollitropin, 75 IU
1/1/2024
Present
J3400
Injection, triflupromazine HCl, up to 20 mg
1/1/2024
Present
J3472
Injection, hyaluronidase, ovine, preservative free, per 1,000 USP units
1/1/2024
Present
J7110
Infusion, dextran 75, 500 ml
1/1/2024
Present
J7131
Hypertonic saline solution, 1 ml
1/1/2024
Present
J7191
Factor VIII (antihemophilic factor (porcine)), per IU
1/1/2024
Present
J7196
Injection, antithrombin recombinant, 50 IU
1/1/2024
Present
J7310
Ganciclovir, 4.5 mg, long-acting implant
1/1/2024
Present
J7315
Mitomycin, ophthalmic, 0.2 mg
1/1/2024
Present
J7330
Autologous cultured chondrocytes, implant
1/1/2024
Present
J7352
Afamelanotide implant, 1 mg
1/1/2024
Present
J9020
Injection, asparaginase, not otherwise specified, 10,000 units
1/1/2024
Present
J9051
Injection, bortezomib (Maia), not therapeutically equivalent to j9041, 0.1 mg
1/1/2024
Present
J9072
Injection, cyclophosphamide, (Dr. Reddy's), 5 mg
1/1/2024
6/30/2024
J9074
Injection, cyclophosphamide (Sandoz), 5 mg
4/1/2024
6/30/2024
J9098
Injection, cytarabine liposome, 10 mg
1/1/2024
Present
J9151
Injection, daunorubicin citrate, liposomal formulation, 10 mg
1/1/2024
Present
J9198
Injection, gemcitabine hydrochloride, (infugem), 100 mg
4/1/2024
Present
J9213
Injection, interferon, alfa-2a, recombinant, 3 million units
1/1/2024
Present
J9214
Injection, interferon, alfa-2b, recombinant, 1 million units
10/1/2023
Present
J9219
Leuprolide acetate implant, 65 mg
1/1/2024
Present
J9225
Histrelin implant (Vantas), 50 mg
1/1/2024
Present
J9247
Injection, melphalan flufenamide, 1 mg
1/1/2024
Present
J9249
Injection, melphalan (apotex), 1 mg
4/1/2024
Present
J9255
Injection, methotrexate (accord) not therapeutically equivalent to j9250 and j9260, 50 mg
1/1/2024
Present
J9258
Injection, paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264, 1 mg
1/1/2024
7/1/2024
J9322
Injection, permetrexed (Bluepoint) not therapeutically equivalent to J9305, 10 mg
1/1/2024
Present
J9324
Injection, pemetrexed (pemrydi rtu), 10 mg
1/1/2024
2/29/2024
J9361
Injection, efbemalenograstim alfa-vuxw, 0.5 mg
7/1/2024
Present
J9393
Injection, fulvestrant (teva) not therapeutically equivalent to j9395, 25 mg
1/1/2024
Present
Q5133
Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg
4/1/2024
4/30/2024
Q5134
Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg
4/1/2024
Present
Q5136
Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg
10/1/2023
Present
Q5137
Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg
7/1/2024
Present
Q5138
Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg
7/1/2024
Present
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