No. J1202 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code.

What is one billing unit of J1202?

One unit of J1202 is 65 mg, as stated in the code's descriptor. Units to report = dose given ÷ 65 mg.

J1202 J-Code: Miglustat — Billing Units & NDCs

In short

J1202 is the HCPCS Level II code for miglustat, oral, 65 mg. One billing unit is 65 mg.

Code

CMS HCPCS file

HCPCS codeJ1202

Billing unit65 mg

Descriptor: Miglustat, oral, 65 mg
Short descriptor: Miglustat oral 65 mg
Code set: HCPCS Level II, maintained by CMS
Effective: Apr 1, 2024

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Units and claim line

Units = dose given ÷ 65 mg. For example, 6500 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Dose given (mg)

HCPCS units (1 unit = 65 mg)

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the dose given to build the claim line.

Find the NDC

Med-Code hasn’t mapped J1202 to specific products yet. Search the FDA NDC Directory for the drug named in the descriptor, and check the route and strength match the code.

Search NDCs for Miglustat

J1202: common questions

Is J1202 a CPT code?: No. J1202 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What is one billing unit of J1202?: One unit of J1202 is 65 mg, as stated in the code's descriptor. Units to report = dose given ÷ 65 mg. J-code billing units.

J1202 — Miglustat, oral, 65 mg

Code

Units and claim line

Find the NDC

J1202: common questions

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