Skip to main content

J1096 HCPCS Level II Code: Dexamethasone, lacrimal ophthalmic insert, 0.1 mg

Coding at a Glance

Drug products
2 NDC products
CMS cross-references
1 related code

Medicare Coverage & Payment

  • CMS short descriptor: Dexametha opth insert 0.1 mg
  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Drugs (pricing indicator 51)
  • BETOS: O1E — Other drugs
  • Last CMS action effective: October 1, 2019

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Related Codes

CMS cross-reference from deleted or non-Medicare codes

The CMS HCPCS Level II code set cross-references these codes (deleted or not valid for Medicare) to this code.

C9048 — Dexamethasone, lacrimal ophthalmic insert, 0.1 mg

Drug products (NDC)

CMS ASP NDC-HCPCS Crosswalk · 2026 Q3

Medicare Part B payment limit (ASP + 6%): $90.02

70382-0204-01 — Dextenza — Ocular Therapeutix (size 1 × qty 1 (0.1 MG per billing unit))

70382-0204-10 — Dextenza — Ocular Therapeutix (size 1 × qty 10 (0.1 MG per billing unit))

From the CMS ASP NDC-HCPCS Crosswalk and Part B Payment Limit File. Payment limits apply per HCPCS billing code, not per package.

Contextual Map

Every relationship of J1096 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Nearest codes (16)

CMS cross-reference

Change history

  • October 1, 2019 — Added to the code set [Change history]— CMS release files (code change ledger)

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, descriptors, coverage and pricing attributes Official source data
CMS HCPCS Alpha-Numeric (ANWEB) release — July 2026 quarterly update Release, file and checksum · Publisher’s page
Drug products Official source data
CMS Medicare Part B Drug Average Sales Price (ASP) Pricing Files (cms.gov/medicare/payment/part-b-drugs/asp-pricing-files) -- the NDC-HCPCS crosswalk and Part B payment limit files — 2026 Q3 (July 2026 release); FDA National Drug Code Directory, product.txt and package.txt (accessdata.fda.gov/cder/ndctext.zip) — Snapshot retrieved 2026-08-24, loaded 2026-08-24 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS HCPCS quarterly update files, ingested into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • October 1, 2019
    Added to the code set
    Dexamethasone, lacrimal ophthalmic insert, 0.1 mg

Nearest Codes in This Family

Official HCPCS Level II classifications closest to J1096 in its code family, with their registry titles.