C9043

Notice

• HCPCS C9043 terminated on December 31, 2019.

Short Description

• Injection, levoleucovorin

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2020

HCPCS Code Added Date

• April 01, 2019

HCPCS Termination Date

• December 31, 2019

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

• J0642

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