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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j7516-cyclosporine-injection-250mg
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    HCPCS J7516: Cyclosporine Injection, 250 mg

    HCPCS Level II code J7516 represents an injectable formulation of cyclosporine, 250 mg, used for parenteral administration of the immunosuppressive agent; service type: drug administration (injectable medication); typical site of service: outpatient infusion center, hospital outpatient department, or clinic.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient receiving J7516 (injection, cyclosporine, 250 mg) is an adult or pediatric patient with an autoimmune or inflammatory condition requiring systemic immunosuppression when oral therapy is contraindicated, not tolerated, or when parenteral dosing is required for rapid therapeutic effect. Examples include severe refractory uveitis, moderate-to-severe psoriasis with poor oral absorption, or organ transplant recipients when intravenous cyclosporine is used in induction or for acute rejection management.

    The clinical workflow begins with an outpatient specialty or inpatient consult (dermatology, ophthalmology, transplant medicine, or rheumatology). The provider documents indication, weight-based dosing or fixed dosing plan, informed consent, and baseline laboratory studies (renal function, electrolytes, drug levels when applicable). Pharmacy prepares the J7516 dose as an injectable formulation; administration may occur in an infusion suite, outpatient clinic, ambulatory surgical center, or inpatient unit depending on indication and monitoring needs. Vital signs and infusion reaction monitoring occur during and after administration. Post-administration documentation includes lot number, amount administered, any unused drug discarded (with modifier JW if applicable), patient tolerance, and follow-up plan for monitoring drug levels and renal function.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourCommon code for the initial infusion encounter when J7516 is administered via IV infusion
    96366Intravenous infusion, each additional hour (List separately in addition to code for primary infusion)Use when infusion of J7516 extends beyond the initial hour and additional time is billed
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance)Used for standalone bolus or intramuscular/subcutaneous injections of medication such as J7516 when administered as an injection rather than an infusion
    36415Collection of venous blood by venipunctureCommonly performed for baseline and follow-up laboratory monitoring (renal function, cyclosporine levels) associated with administration
    94760Noninvasive ear or eye procedures (example placeholder)Data not available in the input.

    Related Modifiers

    8 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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208100000XPhysical Medicine & Rehabilitation PhysicianPhysical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and…
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    208200000XPlastic Surgery PhysicianA plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal sys…
    341800000XMilitary/U.S. Coast Guard TransportTransportation Services · Military/U.S. Coast Guard Transport
    225XP0019XPhysical Rehabilitation Occupational TherapistOccupational therapists are experts at helping people lead as independent a life as possible. Occupational therapists bring an understanding of the p…
    2080P0202XPediatric Cardiology PhysicianA pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and…
    287300000XDeactivated - Christian Science SanitoriumInactive, use 282J00000X

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    H10.021Other mucopurulent conjunctivitis, right eye
    H10.022Other mucopurulent conjunctivitis, left eye
    H10.9Unspecified conjunctivitis
    H11.002Unspecified pterygium of left eye
    H11.003Unspecified pterygium of eye, bilateral
    H16.211Exposure keratoconjunctivitis, right eye
    H16.212Exposure keratoconjunctivitis, left eye
    H16.221Keratoconjunctivitis sicca, not specified as Sjogren's, right eye
    H16.223Keratoconjunctivitis sicca, not specified as Sjogren's, bilateral
    H16.232Neurotrophic keratoconjunctivitis, left eye

    Showing 1–10 of 22

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    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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