Ocular Therapeutix has been assigned a specific and permanent reimbursement J-code for DEXTENZA through the Healthcare Common Procedure Coding System (HSPCS).
The code will be J1096 and will become effective October 1. DEXTENZA is a treatment for ocular inflammation and pain following ophthalmic surgery. The code is from the Centers for Medicare & Medicaid Services
“We are pleased that CMS has issued a unique J-code for DEXTENZA, and has done so one full quarter earlier than expected,” said Antony Mattessich, Ocular Therapeutix president and chief executive officer. “Issuance of the J-code is important for the company as it now enables reimbursement in the office setting as well as in the surgical center, providing increased flexibility to physicians on how they use the product. We anticipate that having a J-code assigned will facilitate reimbursement of and increase access to our product and will give us the opportunity to expand the target market of DEXTENZA to commercial insurers.”
A J-Code is a reimbursement code established by the CMS for the Prospective Payment System used to report drugs that ordinarily cannot be self-administered.