J1745HCPCS Level II

Injection, infliximab, 10 mg

Autoimmune / Anti-TNF
The answer

J1745 is injection, infliximab, 10 mg, billed at 10 mg = 1 Unit. It covers Remicade (Infliximab).

Code detail

Code
J1745
Code set
HCPCS Level II, maintained by CMS
Descriptor
Injection, infliximab, 10 mg
Billable unit
10 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

J1745

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:
10 Units
Based on 10 mg = 1 billable unit (10.0 exact)
Box 24 / HCPCS Quantity Formatted Line:J1745 UN10

Common Worked Examples:

Worked unit conversions for J1745
Dose administeredBillable unitUnits to report
50 mg10 mg = 1 Unit5
100 mg10 mg = 1 Unit10
200 mg10 mg = 1 Unit20
400 mg10 mg = 1 Unit40
1000 mg10 mg = 1 Unit100

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 J1745

1 brand name and 1 generic map to this code.

Generic

Infliximab

Injection, infliximab, 10 mg

Billing detail
Brand

Remicade

Injection, infliximab, 10 mg

Billing detail

Next steps

Find the NDCs for Infliximab

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 J1745 against the current release before submitting a high-value claim.