J3425 — Injection, hydroxocobalamin, intramuscular, 10 mcg
J3425 is a HCPCS Level II code for injection, hydroxocobalamin, intramuscular, 10 mcg. 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 J3425 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
- 20 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 20 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- DME supplier
- 20 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
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 J3425
- Long descriptor
- Injection, hydroxocobalamin, intramuscular, 10 mcg
- Short descriptor
- Hydroxocobalamin im 10mcg
- Added
- January 1, 2024
- 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 J3425
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J3425 is not quite right, the correct code is very often within a few positions of it.
- J3403Revakinagene taroretcel-lwey, per implant
- J3404Injection, zopapogene imadenovec-drba suspension, per therapeutic dose
- J3405Injection, onasemnogene abeparvovec-brve, per treatment
- J3410Injection, hydroxyzine hcl, up to 25 mg
- J3411Injection, thiamine hcl, 100 mg
- J3415Injection, pyridoxine hcl, 100 mg
- J3420Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
- J3424Injection, hydroxocobalamin, intravenous, 25 mg
- J3430Injection, phytonadione (vitamin k), per 1 mg
- J3465Injection, voriconazole, 10 mg
- J3470Injection, hyaluronidase, up to 150 units
- J3471Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)
- J3472Injection, hyaluronidase, ovine, preservative free, per 1000 usp units
- J3473Injection, hyaluronidase, recombinant, 1 usp unit
- J3475Injection, magnesium sulfate, per 500 mg
- J3480Injection, potassium chloride, per 2 meq
Questions about J3425
What is HCPCS code J3425?
J3425 is a HCPCS Level II code for injection, hydroxocobalamin, intramuscular, 10 mcg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J3425?
The CMS HCPCS file marks J3425 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 J3425 paid under the physician fee schedule?
J3425 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).