J7686 — Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg
J7686 is a HCPCS Level II code for treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
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 J7686 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
- 1 unit MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 28 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
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 J7686
- Long descriptor
- Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg
- Short descriptor
- Treprostinil, non-comp unit
- Added
- January 1, 2011
- BETOS
- D1G
- 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 J7686
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7686 is not quite right, the correct code is very often within a few positions of it.
- J7676Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg
- J7677Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram
- J7680Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7681Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7682Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams
- J7683Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7684Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7685Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams
- J7699Noc drugs, inhalation solution administered through dme
- J7799Noc drugs, other than inhalation drugs, administered through dme
- J7999Compounded drug, not otherwise classified
- J8498Antiemetic drug, rectal/suppository, not otherwise specified
- J8499Prescription drug, oral, non chemotherapeutic, nos
- J8501Aprepitant, oral, 5 mg
- J8502Injection, aprepitant (aponvie), 1 mg
- J8510Busulfan; oral, 2 mg
Questions about J7686
What is HCPCS code J7686?
J7686 is a HCPCS Level II code for treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7686?
The CMS HCPCS file marks J7686 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J7686 paid under the physician fee schedule?
J7686 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).