HCPCS J1438

Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

HCPCS Code: J1438: The Healthcare Common Procedure Coding System (HCPCS) is a set of unique alphanumeric codes used to report medical procedures and services to healthcare programs like Medicare and Medicaid. HCPCS codes are used in conjunction with NDC codes for billing and medical documentation puporses. For instance, HCPCS J1438 identifies the type of service or supply used while any of the 11 NDC codes below could be used to specify the exact drug used.
Short Description: Etanercept injection
Long Description: Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
Pricing Indicator: Drugs
Multiple Pricing Indicator: Not applicable as HCPCS priced under one methodology
Coverage Description: Special coverage instructions apply
BETOS Type of Service: Other drugs
HCPCS Classification: List of HCPCS codes for: Drugs Administered Other Than Oral Method, Chemotherapy Drugs (J-codes)

The NDC codes below allow precise billing based on the specific manufacturer and medication used:

NDC	Proprietary Name	Non-Proprietary Name	Dosage Form	Route Name	Company Name	Status
54868-5444	Enbrel				Physicians Total Care, Inc.
58406-010	Enbrel	Etanercept	Solution	Subcutaneous	Immunex Corporation	ACTIVE
58406-021	Enbrel	Etanercept	Solution	Subcutaneous	Immunex Corporation	ACTIVE
58406-032	Enbrel	Etanercept	Solution	Subcutaneous	Immunex Corporation	ACTIVE
58406-044	Enbrel	Etanercept	Solution	Subcutaneous	Immunex Corporation	ACTIVE
58406-055	Enbrel	Etanercept	Solution	Subcutaneous	Immunex Corporation	ACTIVE
58406-425	Enbrel				Immunex Corporation
58406-435	Enbrel				Immunex Corporation
58406-445	Enbrel				Immunex Corporation
58406-455	Enbrel				Immunex Corporation
58406-456	Enbrel				Immunex Corporation