J7599 HCPCS code: Immunosuppressive drug, not otherwise classified
J7599 is the HCPCS Level II code for immunosuppressive drug, not otherwise classified. 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 1 per day on outpatient hospital claims.
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 | 1996-01-01 |
| Last action effective | 2000-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: CMS Workgroup |
| practitioner claims | 1 | Clinical: CMS Workgroup |
Medicare policy articles for this code
- A52474: Immunosuppressive Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (64 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| T86.00 | Unspecified complication of bone marrow transplant | 1 |
| T86.01 | Bone marrow transplant rejection | 1 |
| T86.02 | Bone marrow transplant failure | 1 |
| T86.03 | Bone marrow transplant infection | 1 |
| T86.09 | Other complications of bone marrow transplant | 1 |
| T86.10 | Unspecified complication of kidney transplant | 1 |
| T86.11 | Kidney transplant rejection | 1 |
| T86.12 | Kidney transplant failure | 1 |
| T86.13 | Kidney transplant infection | 1 |
| T86.19 | Other complication of kidney transplant | 1 |
Showing 10 of 64. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J7599
- 1996-01-01: J7599 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 J7599?
J7599 is the HCPCS Level II code for immunosuppressive drug, not otherwise classified. Short descriptor: "Immunosuppressive drug noc".
Does Medicare cover J7599?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J7599?
Medicare policy articles that cite J7599 list 64 covered ICD-10-CM diagnosis codes across 1 article. The most cited include T86.00 (Unspecified complication of bone marrow transplant), T86.01 (Bone marrow transplant rejection), T86.02 (Bone marrow transplant failure). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J7599 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related J75 codes
- J7500 — Azathioprine, oral, 50 mg
- J7501 — Azathioprine, parenteral, 100 mg
- J7502 — Cyclosporine, oral, 100 mg
- J7503 — Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
- J7504 — Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
- J7505 — Muromonab-cd3, parenteral, 5 mg
- J7506 — Prednisone, oral, per 5 mg
- J7507 — Tacrolimus, immediate release, oral, 1 mg
- J7508 — Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
- J7509 — Methylprednisolone oral, per 4 mg
- J7510 — Prednisolone oral, per 5 mg
- J7511 — Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
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Next steps
- Run a reimbursement report for a device billed under J7599
- Watch J7599 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7599
Sources: CMS HCPCS Level II release October 2025; 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.