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Official Description

Injection, glucarpidase, 10 units
Short Descr Injection, glucarpidase
Related Drugs Voraxaze
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) 1 – Medical care
Added Date 10/1/2012
APC Status Indicator Non-Covered Service, not paid under OPPS
ASC Payment Indicator
MUE 700
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
Date
Action
Notes
2024-01-01 Note Payment change (MOG, pricing indicator codes, anesthesia base units, Ambulatory Surgical Centers)
2012-10-01 Added Code Added
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