Clarification of Billing Units for Pegfilgrastim (HCPCS Code J2505)

The NCPDP billing unit for Pegfilgrastim is milliliters (ML). The drug is provided in a 0.6 ML pre-filled syringe containing 6 MG of Pegfilgrastim. The HCPCS code descriptor for this drug (J2505) is listed in milligrams (MG).

Claims must be submitted with the units billed representative of the number of ML provided, not the number of MG. For each 0.6 ML syringe provided, the correct billing unit is 0.6. The NDC-HCPCS Crosswalk will convert the 0.6 ML billed to 1 unit of the HCPCS Code (6 MG) [ 0.6 X 1.66666 = 1].

Providers should ensure they are billing for the number of ML dispensed rather than MG dispensed. Incorrect billing may result in overpayments with subsequent recoupment.

Published by Palmetto GBA as the SADMERC, January 2006. Republished by Noridian as the PDAC, August 2008. Republished by Palmetto GBA as the PDAC, January 2019.

Last Updated: 01/13/2016