Does J2440 require prior authorization?

No, J2440 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for J2440?

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

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`J2440`, Injection, papaverine hcl, up to 60 mg

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Procedure codes listed are for general reference and may not be all-inclusive.
Presence or absence of codes in the policy does not determine coverage or reimbursement; use the written coverage position for determinations.

Coverage determinations must include review of the member's benefit contract / Summary Plan Description (SPD) for defined coverage, exclusions, and limitations (e.g., dollar or duration caps).

Key Coverage Criteria

Medically necessary treatment for sexual dysfunction may be covered if the member's contract does not exclude sexual dysfunction services and the patient has a documented disease process (e.g., diabetes mellitus, hypertension, lipid abnormalities, or peripheral vascular disease).

4 Active Policies

BCBSIL-MED201.030, Sexual Dysfunctions, Assessment and Treatment

BCBSMT-MED201.030, Sexual Dysfunctions, Assessment and Treatment

BCBSNM-MED201.030, Sexual Dysfunctions, Assessment and Treatment

BCBSOK-MED201.030, Sexual Dysfunctions, Assessment and Treatment

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J2440, Injection, papaverine hcl, up to 60 mg