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Code deleted. See J3145.

Official Description

Injection, testosterone undecanoate, 1 mg
Short Descr Inj testosterone undecanoate
Related Drugs Aveed
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(t)
Cross-Reference(s) J3145
BETOS O1E – Other drugs
TOS Code(s) 9 – Other medical items or services
Added Date 10/1/2014
Termination Date 12/31/2014
APC Status Indicator Pass-Through Drugs and Biologicals
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2015-01-01 Deleted Code deleted. See J3145.
2014-10-01 Added Added
Code
Description
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