HCPCS code J0717: Injection, certolizumab pegol, 1 mg

No, J0717 is specifically for drugs administered under the direct supervision of a healthcare professional in a clinic or office setting.

No. You should bill the total milligram dose on a single line item. Since J0717 is for 1 mg, you'll bill the total number of milligrams as the number of units. For example, a 400 mg dose is 400 units, even if it's administered via two 200 mg injections.

The claim will likely be denied. Medical policies from payers like CMS and commercial insurers have very specific criteria for using certolizumab pegol. The patient's diagnosis and medical history must align with these policies for the claim to be considered medically necessary and for it to be paid.