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J2004 - HCPCS Level II | Verity

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HCPCS Level IIdrugActive

J2004

Inj, lidocaine w epinephrine

BETOS: O1E

Effective: 2024-10-01

Description

Injection, lidocaine hcl with epinephrine, 1 mg

Drug Products

FDA-registered drug products mapped to this HCPCS code

Lidocaine.01; 20

Lidocaine Hydrochloride and Epinephrine

NDC: 00362-0898-05INJECTION, SOLUTIONIJ

Septodont, Inc.

Billing: ML

Lidocaine Hydrochloride and Epinephrine10; 10

LIDOCAINE HYDROCHLORIDE and EPINEPHRINE

NDC: 00409-0007-10INJECTION, SOLUTIONIJ

Hospira, Inc.

Billing: ML

Lidocaine Hydrochloride and Epinephrine10; 20

LIDOCAINE HYDROCHLORIDE and EPINEPHRINE

NDC: 00409-0147-10INJECTION, SOLUTIONIJ

Hospira, Inc.

Billing: ML

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Medicare Part B Drug Pricing

ASP-Based Payment

This drug code is paid under Medicare Part B using the Average Sales Price (ASP) + 6% methodology.

ASP pricing data not currently available for this code.

Coverage Policies

No coverage policies currently reference this code

This code is not currently listed in any LCD or NCD coverage policies in our database.

About HCPCS Level II

Healthcare Common Procedure Coding System Level II codes for supplies, equipment, and non-physician services

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