J0135HCPCS Level II

Injection, adalimumab, 20 mg

Autoimmune / Anti-TNF

The answer

J0135 is injection, adalimumab, 20 mg, billed at 20 mg = 1 Unit. It covers Humira (Adalimumab).

Code detail

Code: J0135
Code set: HCPCS Level II, maintained by CMS
Descriptor: Injection, adalimumab, 20 mg
Billable unit: 20 mg = 1 Unit
Category: Autoimmune / Anti-TNF

Dose to units calculation

The quantity reported on the claim is the dose divided by the code’s billable unit.

Interactive Unit Multiplier Calculator

J0135

Calculate the exact number of billable HCPCS units to report on CMS-1500 / 837P claims based on the patient dose and single-dose vial waste.

Administered Patient Dose

Units to report on claim:

5 Units

Based on 20 mg = 1 billable unit (5.0 exact)

Box 24 / HCPCS Quantity Formatted Line:J0135 UN5

Common Worked Examples:

Worked unit conversions for J0135
Dose administered	Billable unit	Units to report
50 mg	20 mg = 1 Unit	2.5
100 mg	20 mg = 1 Unit	5
200 mg	20 mg = 1 Unit	10
400 mg	20 mg = 1 Unit	20
1000 mg	20 mg = 1 Unit	50

Rounding and partial-unit rules vary by payer. Where a dose does not divide evenly, most payers expect the units actually administered plus a separate JW modifier line for the discarded remainder.

Drugs billed under J0135

1 brand name and 1 generic map to this code.

Generic

Adalimumab

Injection, adalimumab, 20 mg

Billing detail

Brand

Humira

Injection, adalimumab, 20 mg

Billing detail

Next steps

Find the NDCs for Adalimumab

FDA drug records with packaging, strengths and the 11-digit HIPAA conversion already applied.

Search the directory

Convert the NDC for the claim

The three leading-zero rules that turn an FDA 10-digit code into the 11-digit form this claim line needs.

Open the guide

Terms used on this page

Billable unitThe quantity denominator built into a HCPCS drug code, which converts an administered dose into the number reported on the claim.Definition J-codeA HCPCS Level II code beginning with J that identifies a drug administered by a clinician rather than self-administered.Definition NDC quantityThe amount of drug actually taken from the package, expressed in the unit named by the unit qualifier.Definition JW modifierReports the amount of a single-dose container that was discarded rather than administered.Definition

HCPCS Level II is updated quarterly by CMS. Verify J0135 against the current release before submitting a high-value claim.