In short

J8565 is the HCPCS Level II code for gefitinib, oral, 250 mg. One billing unit is 250 mg.

Code

CMS HCPCS file
HCPCS codeJ8565
Billing unit250 mg
Descriptor
Gefitinib, oral, 250 mg
Short descriptor
Gefitinib oral
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2015

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

Units and claim line

Units = dose given ÷ 250 mg. For example, 25000 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 J8565 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 Gefitinib

J8565: common questions

Is J8565 a CPT code?
No. J8565 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 J8565?
One unit of J8565 is 250 mg, as stated in the code's descriptor. Units to report = dose given ÷ 250 mg. J-code billing units.

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