HCPCS Code J7644

Official Description

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram

Short Descr	Ipratropium bromide non-comp
Related Drugs	Ipratropium Bromide
Coverage	Special coverage instructions apply
Pricing Indicator(s)	51 – Drugs
MPI	A – Not applicable, as HCPCS priced under one methodology
Processing Note	MEDICARE BENEFIT POLICY MANUAL, PUB 100.2, CHAPTER 15, SECTION 110.3 (100.02,15,110.3).
BETOS	D1G – Drugs Administered through DME
TOS Code(s)	1 – Medical care
Added Date	1/1/2000
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 Not Billable to the MAC
MUE	3
MUE	279
OTS Orthotic	No
CCS Clinical Classification	240 - Medications (Injections, infusions and other forms)

KO	Single drug unit dose formulation
JZ	Zero drug amount discarded/not administered to any patient
GA	Waiver of liability statement issued as required by payer policy, individual case
CR	Catastrophe/disaster related
GW	Service not related to the hospice patient's terminal condition
KX	Requirements specified in the medical policy have been met
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
EY	No physician or other licensed health care provider order for this item or service
K0	Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.
4K	Fingerprint for recipient allelotype (allogeneic transplant)
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.
76	Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AQ	Physician providing a service in an unlisted health professional shortage area (hpsa)
CO	Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
GC	This service has been performed in part by a resident under the direction of a teaching physician
GV	Attending physician not employed or paid under arrangement by the patient's hospice provider
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
GZ	Item or service expected to be denied as not reasonable and necessary
JW	Drug amount discarded/not administered to any patient
KQ	Second or subsequent drug of a multiple drug unit dose formulation
KT	Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
LD	Left anterior descending coronary artery
PD	Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q6	Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
TB	Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
UD	Medicaid level of care 13, as defined by each state
UH	Services provided in the evening
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
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