J0613 — Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg
J0613 is a HCPCS Level II code for injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J0613 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 800 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 800 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J0613
- Long descriptor
- Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg
- Short descriptor
- Calcium glucon (wg critical)
- Added
- April 1, 2023
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J0613
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J0613 is not quite right, the correct code is very often within a few positions of it.
- J0605Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)
- J0606Injection, etelcalcetide, 0.1 mg
- J0607Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)
- J0608Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)
- J0609Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)
- J0610Injection, calcium gluconate (fresenius kabi), per 10 mlterminated
- J0611Injection, calcium gluconate (wg critical care), per 10 mlterminated
- J0612Injection, calcium gluconate, not otherwise specified, 10 mg
- J0614Injection, treosulfan, 50 mg
- J0615Calcium acetate, oral, 23 mg (for esrd on dialysis)
- J0616Injection, metoprolol tartrate, 1 mg
- J0618Injection, calcium chloride, 2 mg
- J0620Injection, calcium glycerophosphate and calcium lactate, per 10 ml
- J0630Injection, calcitonin salmon, up to 400 units
- J0636Injection, calcitriol, 0.1 mcg
- J0637Injection, caspofungin acetate, 5 mg
Questions about J0613
What is HCPCS code J0613?
J0613 is a HCPCS Level II code for injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J0613?
The CMS HCPCS file marks J0613 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J0613 paid under the physician fee schedule?
J0613 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).