## **What is the HCPCS code J1568 for?**
The HCPCS code J1568 is meant to designate an intravenous immune globulin (Octagam) injection. The immune globulin is non-lyophilized (e.g., liquid) and has a dosage of 500 mg. This type of immune globulin intravenous injection shot is meant to provide a booster to the body's immune system to help it combat some immunodeficiencies and immune system disorders. This treatment not only helps boost the immune system, but it also helps reduce the effects of infections.
This injected treatment is usually administered in hospitals and outpatient clinics. Pharmacists often prepare the solution, and doctors or nurse practitioners are the ones who inject it into patients. Since this is an intravenous injection, it requires an IV catheter and tubing.
## **Documentation requirements for J1568**
As with any procedure, especially involving injecting drugs into patients, it's important to document the following before you file for a claim that includes this code:
- The full name of the personnel who administered the injection + their credentials
- The name and address of the facility where the injection was administered
- The full name of the patient
- The date and time of the drug administration by injection
- Patient records showing they've been diagnosed with a qualifying condition (e.g., primary immunodeficiency diseases/disorders, chronic inflammatory demyelinating polyneuropathy, idiopathic thrombocytopenic purpura)
- Patient records that other treatments have been provided, and the patient has had inadequate responses
- Medical necessity of immune support
- Blood test results that assess the patient's immune system
The exact dosage of the injection
## **Billing requirements for J1568**
Besides the documentation requirements above, please note the following billing guidelines for this HCPCS code:
- They must reflect the dosage given over the course of the treatment.
- Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication.
Since this is a type of medicine administered via intravenous infusion, please make sure that the CPT code 96365 accompanies all the other codes you're using.
## **Other similar codes**
- J1556 - Injection, immune globulin (Bivigam), 500 mg
- J1558 - Injection, immune globulin (xembify), 100 mg
- J1559 - Injection, immune globulin (Hizentra), 100 mg
- J1561 - Injection, immune globulin, (Gamunex/Gamunex-C/Gammaked), nonlyophilized (e.g., liquid), 500 mg
- J1569 - Injection, immune globulin (Gammagard liquid), nonlyophilized (e.g., liquid), 500 mg
Frequently asked questions
