J3425 HCPCS code: Injection, hydroxocobalamin, intramuscular, 10 mcg
J3425 is the HCPCS Level II code for injection, hydroxocobalamin, intramuscular, 10 mcg. In 2024 Medicare paid an average of $0.03 per service for J3425 across 1,012 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 20 per day on DME suppliers. In 2024, about 27 clinicians billed Medicare for J3425 for 143 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2024-01-01 |
| Last action effective | 2025-01-01 |
Who bills J3425 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 27 |
| Medicare beneficiaries | 143 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3425, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 1,012 | 143 | $0.03 | $0.03 |
States with the most J3425 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 347 | $0.01 |
| Maryland | 72 | $0.28 |
| Georgia | 23 | $0.01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 20 | Prescribing Information |
| outpatient hospital claims | 20 | Prescribing Information |
| practitioner claims | 20 | Prescribing Information |
Medicare policy articles for this code
- A57755: Billing and Coding: Vitamin B12 Injections (First Coast Service Options, Inc. (MAC - Part B))
Covered diagnoses (44 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| D51.0 | Vitamin B12 deficiency anemia due to intrinsic factor deficiency | 1 |
| D51.1 | Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption with proteinuria | 1 |
| D51.2 | Transcobalamin II deficiency | 1 |
| D51.3 | Other dietary vitamin B12 deficiency anemia | 1 |
| D51.8 | Other vitamin B12 deficiency anemias | 1 |
| D51.9 | Vitamin B12 deficiency anemia, unspecified | 1 |
| D52.0 | Dietary folate deficiency anemia | 1 |
| D52.1 | Drug-induced folate deficiency anemia | 1 |
| D52.8 | Other folate deficiency anemias | 1 |
| D52.9 | Folate deficiency anemia, unspecified | 1 |
Showing 10 of 44. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J3425
- 2024-01-01: J3425 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 J3425?
J3425 is the HCPCS Level II code for injection, hydroxocobalamin, intramuscular, 10 mcg. Short descriptor: "Hydroxocobalamin im 10mcg".
How much does Medicare pay for J3425?
In 2024, the average Medicare payment was $0.03 per service (average allowed $0.03).
Does Medicare cover J3425?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J3425?
Medicare policy articles that cite J3425 list 44 covered ICD-10-CM diagnosis codes across 1 article. The most cited include D51.0 (Vitamin B12 deficiency anemia due to intrinsic factor deficiency), D51.1 (Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption with proteinuria), D51.2 (Transcobalamin II deficiency). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J3425 can be billed per day?
20 on DME suppliers; 20 on outpatient hospital claims; 20 on practitioner claims (NCCI medically unlikely edits).
Related J34 codes
- J3400 — Injection, triflupromazine hcl, up to 20 mg
- J3401 — Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
- J3402 — Injection, remestemcel-l-rknd, per therapeutic dose
- J3403 — Revakinagene taroretcel-lwey, per implant
- J3404 — Injection, zopapogene imadenovec-drba suspension, per therapeutic dose
- J3405 — Injection, onasemnogene abeparvovec-brve, per treatment
- J3406 — Injection, omidubicel-onlv, per therapeutic dose
- J3410 — Injection, hydroxyzine hcl, up to 25 mg
- J3411 — Injection, thiamine hcl, 100 mg
- J3415 — Injection, pyridoxine hcl, 100 mg
- J3420 — Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
- J3424 — Injection, hydroxocobalamin, intravenous, 25 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J3425
- Watch J3425 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3425
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.