OMIDRIA J Code: J1097
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
Drug & Product Overview
About OMIDRIA
Omidria is a medication aligned to the HCPCS J Code: J1097 for billing, pricing, and reimbursement purposes in the United States. Classified under Ophthalmology, it is administered via the intraocular or ophthalmic routes and manufactured by Rayner Surgical.
Manufacturers, reach out to us to add more information.
NDC Code Information
3 NDC packages are crosswalked to J1097. Package detail is available to logged-in subscribers.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| •••••-••••-•• Log in to view | OMIDRIA | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | OMIDRIA | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | OMIDRIA | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
OMIDRIA Pricing & Reimbursement
National median reimbursement across major commercial payers.
Create an account on PayerPrice for more information →
OMIDRIA 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 |
|---|---|
| 66984 | Uncomplicated cataract surgery |
| 66982 | Complex cataract surgery with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification) and performed using devices or techniques not generally used in routine cataract surgery (e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis). |
| 66983 Login for More | Intracapsular cataract extraction with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification). Login for More |
CMS has identified Omidria (J1097) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →
OMIDRIA Medically Unlikely Edits (MUE)
The most billing units of J1097 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 ml.
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 →
OMIDRIA Clinical Information
Indications and drug classification.
This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.
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Frequently Asked Questions
Is there an available Omidria billing and coding guide?
Are there any available Omidria patient assistance programs?
Where can I find Omidria prescribing information?
Where can I find Omidria side effect information?
Does billing OMIDRIA require JZ/JW wastage modifiers?
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