In short

J7294 is the HCPCS Level II code for segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each. One billing unit is 0.013mg per 24 hours; yearly vaginal system.

Code

CMS HCPCS file
HCPCS codeJ7294
Billing unit0.013mg per 24 hours; yearly vaginal system
Descriptor
Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each
Short descriptor
Seg acet and eth estr yearly
Code set
HCPCS Level II, maintained by CMS
Effective
Oct 1, 2021

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

Units and claim line

Units = dose given ÷ 0.013mg per 24 hours; yearly vaginal system. For example, 1.3 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Find the NDC

Med-Code hasn’t mapped J7294 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 Segesterone acetate and ethinyl estradiol 0.15mg

J7294: common questions

Is J7294 a CPT code?
No. J7294 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 J7294?
One unit of J7294 is 0.013mg per 24 hours; yearly vaginal system, as stated in the code's descriptor. Units to report = dose given ÷ 0.013mg per 24 hours; yearly vaginal system. J-code billing units.

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