J3490 Unclassified drugs

CPT crosslinks for J3490 CPT/HCPCS code

11980 Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)
22899 Unlisted procedure, spine
27599 Unlisted procedure, femur or knee
28890 Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia
31513 Laryngoscopy, indirect; with vocal cord injection
31570 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic
31571 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope
33999 Unlisted procedure, cardiac surgery
36593 Declotting by thrombolytic agent of implanted vascular access device or catheter
37799 Unlisted procedure, vascular surgery
43201 Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance
43236 Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance
43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty
44799  Unlisted procedure, small intestine
53899 Unlisted procedure, urinary system
64612 Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)
64640 Destruction by neurolytic agent; other peripheral nerve or branch
64999 Unlisted procedure, nervous system
67028 Intravitreal injection of a pharmacologic agent (separate procedure)
67345 Chemodenervation of extraocular muscle
76499 Unlisted diagnostic radiographic procedure
76999 Unlisted ultrasound procedure (eg, diagnostic, interventional)
78451 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)
78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection
78453 Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)
78454 Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection
78466 Myocardial imaging, infarct avid, planar; qualitative or quantitative
78468 Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique
78469 Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification
78472 Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing
78473 Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification
78481 Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification
78483 Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification
78494 Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing
78496 Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (List separately in addition to code for primary procedure)
78699 Unlisted nervous system procedure, diagnostic nuclear medicine
82016 Acylcarnitines; qualitative, each specimen
82017 Acylcarnitines; quantitative, each specimen
82286 Bradykinin
82485 Chondroitin B sulfate, quantitative
84255 Selenium
84525 Urea nitrogen; semiquantitative (eg, reagent strip test)
84999 Unlisted chemistry procedure
85337 Thrombomodulin
86343 Leukocyte histamine release test (LHR)
86723 Antibody; Listeria monocytogenes
88371 Protein analysis of tissue by Western Blot, with interpretation and report
88372 Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each
92265 Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report
92548 Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report
92700 Unlisted otorhinolaryngological service or procedure
92970 Cardioassist-method of circulatory assist; internal
92971 Cardioassist-method of circulatory assist; external
93015 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report
93016 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report
93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report
93018 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only
93350 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report
93351 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional
93352 Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure)
93740 Temperature gradient studies
93799 Unlisted cardiovascular service or procedure
95199 Unlisted allergy/clinical immunologic service or procedure
95806 Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)
95860 Needle electromyography; 1 extremity with or without related paraspinal areas
95861 Needle electromyography; 2 extremities with or without related paraspinal areas
95863 Needle electromyography; 3 extremities with or without related paraspinal areas
95867 Needle electromyography; cranial nerve supplied muscle(s), unilateral
95868  Needle electromyography; cranial nerve supplied muscles, bilateral
95869 Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12)
95870 Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters
95999 Unlisted neurological or neuromuscular diagnostic procedure
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour
96361 Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
96367 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)
96368 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)
96369 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)
96370 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
96371 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (List separately in addition to code for primary procedure)
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
96373 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial
96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial  substance/drug
96375 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)
96376 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)
96379 Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion
96401 Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
96402 Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic
96405 Chemotherapy administration; intralesional, up to and including 7 lesions
96406 Chemotherapy administration; intralesional, more than 7 lesions
96409 Chemotherapy administration; intravenous, push technique, single or initial substance/drug
96411 Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)
96413 Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415 Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)
96416 Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump
96417 Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure)
96420 Chemotherapy administration, intra-arterial; push technique
96422 Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour
96423 Chemotherapy administration, intra-arterial; infusion technique, each additional hour (List separately in addition to code for primary procedure)
96425 Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump
96440 Chemotherapy administration into pleural cavity, requiring and including thoracentesis
96446 Chemotherapy administration into the peritoneal cavity via indwelling port or catheter
96450 Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture
96521 Refilling and maintenance of portable pump
96522 Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)
96523 Irrigation of implanted venous access device for drug delivery systems
96542 Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents
96549 Unlisted chemotherapy procedure
97026 Application of a modality to 1 or more areas; infrared
97033 Application of a modality to 1 or more areas; iontophoresis, each 15 minutes
97039 Unlisted modality (specify type and time if constant attendance)
97799 Unlisted physical medicine/rehabilitation service or procedure
99199 Unlisted special service, procedure or report

Modifier Crosslinks  J3490 CPT/HCPCS code

ER Items and services furnished by a provider-based, off-campus emergency department
GA Waiver of liability statement issued as required by payer policy, individual case
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
JG Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
KD Drug or biological infused through dme
KX Requirements specified in the medical policy have been met
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
TB Drug or biological acquired with 340b drug pricing program discount, reported for info