J0897HCPCS Level II

Injection, denosumab, 1 mg

Bone Health / RANKL
The answer

J0897 is injection, denosumab, 1 mg, billed at 1 mg = 1 Unit. It covers Prolia, Xgeva (Denosumab).

Code detail

Code
J0897
Code set
HCPCS Level II, maintained by CMS
Descriptor
Injection, denosumab, 1 mg
Billable unit
1 mg = 1 Unit
Category
Bone Health / RANKL

Dose to units calculation

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

Interactive Unit Multiplier Calculator

J0897

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.

MG
Units to report on claim:
100 Units
Based on 1 mg = 1 billable unit (100.0 exact)
Box 24 / HCPCS Quantity Formatted Line:J0897 UN100

Common Worked Examples:

Worked unit conversions for J0897
Dose administeredBillable unitUnits to report
50 mg1 mg = 1 Unit50
100 mg1 mg = 1 Unit100
200 mg1 mg = 1 Unit200
400 mg1 mg = 1 Unit400
1000 mg1 mg = 1 Unit1000

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 J0897

2 brand names and 1 generic map to this code.

Generic

Denosumab

Injection, denosumab, 1 mg

Billing detail
Brand

Prolia

Injection, denosumab, 1 mg

Billing detail
Brand

Xgeva

Injection, denosumab, 1 mg

Billing detail

Next steps

Find the NDCs for Denosumab

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 J0897 against the current release before submitting a high-value claim.