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NDC
HCPCS
HCPCS Description
NDC Label
Route of Administration
70710-1663-07
J3420
INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG
CYANOCOBALAMIN 1000 MCG/1 ML
IJ
70710-1664-06
J3420
INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG
CYANOCOBALAMIN 1000 MCG/1 ML
IJ
70092-0086-44
J0330
INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG
SUCCINYLCHOLINE CHLORIDE (SULFITE-FREE) 20 MG/1 ML
IV
70092-0087-46
J0330
INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG
SUCCINYLCHOLINE CHLORIDE (5X10ML,SULFITE-FREE) 20 MG/1 ML
IV
70092-0097-43
J3010
INJECTION, FENTANYL CITRATE, 0.1 MG
FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML
IV
70092-0098-44
J3010
INJECTION, FENTANYL CITRATE, 0.1 MG
FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML
IV
70092-0099-49
J3010
INJECTION, FENTANYL CITRATE, 0.1 MG
FENTANYL (MONOJECT SYRINGE,PF) 50 MCG/1 ML
IV
70092-0100-50
J3010
INJECTION, FENTANYL CITRATE, 0.1 MG
FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML
IV
70092-0111-48
J1170
INJECTION, HYDROMORPHONE, UP TO 4 MG
HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9%
IV
70092-0112-49
J1170
INJECTION, HYDROMORPHONE, UP TO 4 MG
HYDROMORPHONE HCL-SODIUM CHLORIDE (MONOJECT SYRINGE,PF) 0.2 MG/1 ML-0.9%
IV
70092-0113-79
J1170
INJECTION, HYDROMORPHONE, UP TO 4 MG
HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9%
IV
70092-0114-50
J1170
INJECTION, HYDROMORPHONE, UP TO 4 MG
HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9%
IV
HCPCS Code
Description
Billing Unit
SA Type
L3924
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf
Each
Y
L3925
Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf
Each
Y
L3927
Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g. static or ring type), may include soft interface material, prefabricated, off-the-shelf
Each
Y
L3929
Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Each
Y
L3930
Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf
Each
Y
L3931
Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbucles, elastic bands/springs, may inculde soft interface material, straps, prefabricated, includes fitting and adjustment
Each
Y
L3933
FO, without joints, may include soft interface, custom fabricated, includes fitting and adjustment
Each
Y
L3935
FO, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment
Each
Y
L3956
Addition of joint to upper extremity orthosis, any material; per joint
Each
Y
L3960
SEWHO, abduction positioning, airplane design, prefabricated, includes fitting and adjustment
Each
Y
L3961
SEWHO, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
Each
Y
L3962
SEWHO, abduction positioning, Erb's palsy design, prefabricated, includes fitting and adjustment
Each
Y
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