HCPCS J0135
Adalimumab injection
About HCPCS J0135
Injection, adalimumab, 20 mg
Coding Tips for HCPCS J0135
Series-level billing guidance from the PayerReady Medical Coding Team. J-codes follow specific Medicare Part B and DME rules. These are the gotchas that drive denials.
Drugs administered other than oral. The dominant outpatient drug code family. Bill the J-code with the units corresponding to the dose given (J3490 dosage = 1 mg per unit unless otherwise stated, J9201 = 100 mg, etc.). Verify per-code units in the CMS Quarterly ASP Pricing File, the most common denial reason for J-codes is incorrect units.
NDC reporting required on most commercial claims and Medicaid. Format: 11-digit NDC in 5-4-2 layout, qualifier N4, with dispensed quantity and unit of measure. Missing NDC is a clean-claims auto-reject.
Modifier JW (drug discarded/wasted) is required for single-dose vials when any drug is discarded. Bill the administered units on one line, the discarded units on a second line with JW. CMS recovers waste payments aggressively in audits.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team