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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0172-aducanumab-injection-2mg
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    HCPCS J0172: Injection, aducanumab-avwa, 2 mg

    HCPCS Level II code J0172 describes the single-dose injectable medication aducanumab-avwa, 2 mg, used for intravenous infusion therapy; the service type is therapeutic monoclonal antibody infusion and the typical site of service is outpatient infusion center or hospital outpatient department.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an older adult diagnosed with early symptomatic Alzheimer disease or mild cognitive impairment due to Alzheimer pathology who is being treated in a neurology infusion center. The patient presents for a scheduled intravenous infusion of J0172 (aducanumab-avwa), dosed in 2 mg units per billing increment and administered per the FDA-approved dosing schedule after baseline evaluation. The clinical workflow includes: pre-infusion nursing assessment (vital signs, weight, review of concurrent medications and allergies), verification of the most recent brain MRI for amyloid-related imaging abnormalities (ARIA), informed consent documentation specific to aducanumab-avwa risks and benefits, pharmacy preparation and verification of dose, administration by an infusion nurse under neurologist or infusion center physician oversight, monitoring during and for a period after infusion for infusion reactions or neurologic changes, and documentation of dose, lot number, and any adverse events. Follow-up visits include periodic cognitive assessments and interval MRIs per prescribing and payer requirements.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourUsed to bill the initial infusion encounter administration time when J0172 is infused as the primary therapeutic agent
    96366Intravenous infusion, each additional hourUsed for extended infusion duration beyond the initial hour when clinically necessary for infusion of J0172
    96374Injection, therapeutic, prophylactic, or diagnostic; intravenous push, single or initial substance/drugApplicable if a bolus medication (e.g., premedication) is administered as an IV push during the infusion visit
    96376Each additional sequential IV push of a new substance/drugFor additional IV push medications given during the same encounter (e.g., antiemetic or antihistamine)
    77053Magnetic resonance imaging, brain, without and with contrast when performed for treatment monitoringOrdered before or during the treatment course to monitor for ARIA and treatment safety in patients receiving J0172

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    332B00000XDurable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    225XR0403XDriving and Community Mobility Occupational TherapistOccupational therapists can optimize and prolong an older driver's ability to drive safely and ease the transition to other forms of transportation if…
    146D00000XPersonal Emergency Response AttendantIndividuals that are specially trained to assist patients living at home with urgent/emergent situations. These individuals must be able to perform C…
    1223P0106XOral and Maxillofacial Pathology DentistryThe specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and m…
    2080P0204XPediatric Emergency Medicine (Pediatrics) PhysicianA pediatrician who has special qualifications to manage emergencies in infants and children.

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E03.9Hypothyroidism, unspecified
    E11.9Type 2 diabetes mellitus without complications
    F01.50Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F07.81Postconcussional syndrome
    F10.27Alcohol dependence with alcohol-induced persisting dementia
    F19.27Other psychoactive substance dependence with psychoactive substance-induced persisting dementia
    G30.0Alzheimer's disease with early onset
    G30.1Alzheimer's disease with late onset

    Showing 1–10 of 26

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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