HCPCS Code J1050

Official Description

Injection, medroxyprogesterone acetate, 1 mg

Short Descr	Medroxyprogesterone acetate
Related Drugs	Medroxyprogesterone Acetate
Coverage	Carrier Priced
Pricing Indicator(s)	51 – Drugs
MPI	A – Not applicable, as HCPCS priced under one methodology
BETOS	O1E – Other drugs
TOS Code(s)	1 – Medical care
Added Date	1/1/2013
Status Code	Excluded from Physician Fee Schedule by Regulation
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Packaged into APC Rates
ASC Payment Indicator	Packaged service/item; no separate payment made.
MUE	1000
MUE	0
OTS Orthotic	No
CCS Clinical Classification	240 - Medications (Injections, infusions and other forms)

JZ	Zero drug amount discarded/not administered to any patient
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
UD	Medicaid level of care 13, as defined by each state
FP	Service provided as part of family planning program
GA	Waiver of liability statement issued as required by payer policy, individual case
U6	Medicaid level of care 6, as defined by each state
CR	Catastrophe/disaster related
SA	Nurse practitioner rendering service in collaboration with a physician
JW	Drug amount discarded/not administered to any patient
GC	This service has been performed in part by a resident under the direction of a teaching physician
GZ	Item or service expected to be denied as not reasonable and necessary
TB	Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
U8	Medicaid level of care 8, as defined by each state
U1	Medicaid level of care 1, as defined by each state
X1	Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
KX	Requirements specified in the medical policy have been met
JG	Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GX	Notice of liability issued, voluntary under payer policy
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
SL	State supplied vaccine
GW	Service not related to the hospice patient's terminal condition
AQ	Physician providing a service in an unlisted health professional shortage area (hpsa)
GV	Attending physician not employed or paid under arrangement by the patient's hospice provider
Q1	Routine clinical service provided in a clinical research study that is in an approved clinical research study
QW	Clia waived test
SB	Nurse midwife
XE	Separate encounter, a service that is distinct because it occurred during a separate encounter
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
LT	Left side (used to identify procedures performed on the left side of the body)
RT	Right side (used to identify procedures performed on the right side of the body)
XS	Separate structure, a service that is distinct because it was performed on a separate organ/structure