ALGLUCOSIDASE ALFA J Code: J0220
Injection, alglucosidase alfa, 10 mg, not otherwise specified
Drug & Product Overview
About ALGLUCOSIDASE ALFA
Alglucosidase ALFA is a medication aligned to the HCPCS J Code: J0220 for billing, pricing, and reimbursement purposes in the United States. It is an Enzyme Replacement Therapy drug administered via the intravenous route.
Manufacturers, reach out to us to add more information.
NDC Code Information
No NDC packages are aligned to J0220 in publicly available CMS files.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| No public NDC alignments | ||||
ALGLUCOSIDASE ALFA Pricing & Reimbursement
National median reimbursement across major commercial payers.
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ALGLUCOSIDASE ALFA CPT Administration Codes
The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.
| CPT Code | Description |
|---|---|
| 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) |
CMS does not include Alglucosidase ALFA (J0220) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0220. Wastage billing guide →
ALGLUCOSIDASE ALFA Medically Unlikely Edits (MUE)
The most billing units of J0220 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg. The limit is different in the office and the hospital. Use the one for your setting.
MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →
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Frequently Asked Questions
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