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First appearance of deletion in codebook. See J2470.

Official Description

Injection, pantoprazole sodium, per vial
Short Descr Inj pantoprazole sodium, via
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(T)
BETOS O1E – Other drugs
TOS Code(s) 9 – Other medical items or services
Added Date 1/1/2002
Termination Date 6/30/2024
APC Status Indicator Items and Services Packaged into APC Rates
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
JZ Zero drug amount discarded/not administered to any patient
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Date
Action
Notes
2025-01-01 Deleted First appearance of deletion in codebook. See J2470.
2024-06-30 Deleted Code deleted, see J2470.
2002-01-01 Added Code added 1/1/2002
Code
Description
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