HCPCS Code J8540: Dexamethasone, Oral, 0.25 mg

No. J1100 denotes injected dexamethasone and is inappropriate for oral administration. J8540 should be used when the drug is administered orally; note that payer policies may vary, and some may not cover orally administered dexamethasone outside chemotherapy contexts.

Claims will likely be denied as non-covered unless accompanied by the correct modifier (GA/GZ) and documentation (e.g., ABN for GA). J8540 alone, outside a covered oncology antiemetic context, often falls outside coverage.

Unit billing corresponds to 0.25 mg per unit. The quantity should reflect actual dosage dispensed and align with coverage limits (typically up to 48 hours of therapy). For example, a total dose of 10 mg equals 40 units; exceeding 48 hours of coverage may result in denial.