Does J0600 require prior authorization?

No, J0600 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for J0600?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT J0600, Injection, edetate calcium disodium, up to 1000 mg | No Prior Auth

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Procedure codes listed in the policy are provided only as a general reference and may not be all‑inclusive.
Coverage determinations must include review of the member's benefit contract or Summary Plan Description (SPD) to determine defined coverage, exclusions, and limitations (e.g., dollar or duration caps).

Chelation therapy is covered as medically necessary for heavy metal toxicity and overload conditions (e.g., iron, copper, lead, aluminum).
Chelation therapy is consideredmedically necessarytreatment for individuals with relevant clinical findings suggestive of heavy metal toxicity and a probable exposure history inanyof the following conditions when confirmed by laboratory testing*:
Individuals with disorders of iron metabolism (for example, primary or secondary hemochromatosis);or
Lead overload in cases of acute or long-term lead exposure;or
Individuals with disorders of copper metabolism (for example, Wilsonâs disease);or
Arsenic, mercury, iron, copper, or gold poisoning when long-term exposure and toxicity has been confirmed;or

ANTHEM-CG-MED-90, Chelation Therapy

UHC-POL-chelation-therapy-non-overload-conditions, Chelation Therapy

BCBSIL-THE801.008, Chelation Therapy for Off-Label Uses

BCBSMT-THE801.008, Chelation Therapy for Off-Label Uses

BCBSNM-THE801.008, Chelation Therapy for Off-Label Uses

BCBSOK-THE801.008, Chelation Therapy for Off-Label Uses

UMR-POL-UMR-chelation-therapy-non-overload-conditions, Chelation Therapy

SUREST-POL-SUREST-chelation-therapy-non-overload-conditions, Chelation Therapy

Ask Backwork about documentation requirements, denial risks, or coverage in your state.