C9139

Notice

• HCPCS C9139 terminated on December 31, 2016.

Short Description

• Idelvion, 1 i.u.

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2017

HCPCS Code Added Date

• October 01, 2016

HCPCS Termination Date

• December 31, 2016

HCPCS Pricing Indicator Code

• 53 = Statute

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Statute Number

• 1833(t)

HCPCS Cross Reference Code

• J7202

HCPCS Type Of Service Code

• 9 = Other medical items or servicesF = Ambulatory surgical center (facility usage for surgical services)

HCPCS Anesthesia Base Unit Quantity

• 0