OCRIPLASMIN J Code: J7316
Injection, ocriplasmin, 0.125 mg
Drug & Product Overview
About OCRIPLASMIN
Ocriplasmin is a medication aligned to the HCPCS J Code: J7316 for billing, pricing, and reimbursement purposes in the United States. Classified under Ophthalmology, it is administered via the intravitreal route.
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NDC Code Information
No NDC packages are aligned to J7316 in publicly available CMS files.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| No public NDC alignments | ||||
OCRIPLASMIN Pricing & Reimbursement
National median reimbursement across major commercial payers.
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OCRIPLASMIN 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 |
|---|---|
| 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) 67028 |
CMS does not include Ocriplasmin (J7316) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7316. Wastage billing guide →
OCRIPLASMIN Medically Unlikely Edits (MUE)
The most billing units of J7316 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.125 mg.
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
Is there an available Ocriplasmin billing and coding guide?
Are there any available Ocriplasmin patient assistance programs?
Where can I find Ocriplasmin prescribing information?
Where can I find Ocriplasmin side effect information?
Does billing Ocriplasmin require JZ/JW wastage modifiers?
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