J1931 HCPCS code: Injection, laronidase, 0.1 mg
J1931 is the HCPCS Level II code for injection, laronidase, 0.1 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 609 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2005-01-01 |
| Last action effective | 2005-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 609 | Clinical: CMS Workgroup |
| outpatient hospital claims | 609 | Clinical: CMS Workgroup |
| practitioner claims | 609 | Clinical: CMS Workgroup |
What changed for J1931
- 2005-01-01: J1931 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J1931?
J1931 is the HCPCS Level II code for injection, laronidase, 0.1 mg. Short descriptor: "Laronidase injection".
Does Medicare cover J1931?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1931 can be billed per day?
609 on DME suppliers; 609 on outpatient hospital claims; 609 on practitioner claims (NCCI medically unlikely edits).
Related J19 codes
- J1920 — Injection, labetalol hydrochloride, 5 mg
- J1921 — Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg
- J1930 — Injection, lanreotide, 1 mg
- J1932 — Injection, lanreotide, (cipla), 1 mg
- J1938 — Injection, furosemide, 1 mg
- J1939 — Injection, bumetanide, 0.5 mg
- J1940 — Injection, furosemide, up to 20 mg
- J1941 — Injection, furosemide (furoscix), 20 mg
- J1942 — Injection, aripiprazole lauroxil, 1 mg
- J1943 — Injection, aripiprazole lauroxil, (aristada initio), 1 mg
- J1944 — Injection, aripiprazole lauroxil, (aristada), 1 mg
- J1945 — Injection, lepirudin, 50 mg
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Next steps
- Run a reimbursement report for a device billed under J1931
- Watch J1931 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1931
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.