J0638 Canakinumab injection
Also known as: canakinumab, Ilaris, IL-1 beta antagonist
Canakinumab injection, a monoclonal antibody against interleukin-1 beta for treatment of cryopyrin-associated periodic syndromes and gout.
In Plain Language
inflammation blocker injection; rare genetic fever and gout treatment
Clinical Context
Monoclonal antibody targeting interleukin-1 beta, indicated for cryopyrin-associated periodic syndromes (CAPS), familial Mediterranean fever, and acute gout attacks.
RVU Information
CPT J0638 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
J-codes represent drugs administered by a healthcare provider (not self-administered). Documentation must include the drug name, dosage, route of administration, and medical necessity. Most payers require the National Drug Code (NDC) on the claim. Bill the appropriate administration code (96365-96379) in addition to the drug code.
Specialties
Frequently Asked Questions
What is CPT code J0638?
CPT J0638 (Canakinumab injection) is a J Codes (Drugs) code. Canakinumab injection, a monoclonal antibody against interleukin-1 beta for treatment of cryopyrin-associated periodic syndromes and gout.
How is J0638 administered?
CPT J0638 is administered by a healthcare provider, typically via injection or infusion. Monoclonal antibody targeting interleukin-1 beta, indicated for cryopyrin-associated periodic syndromes (CAPS), familial Mediterranean fever, and acute gout attacks. It is used by rheumatology, immunology, genetic medicine.
When is CPT J0638 used?
Monoclonal antibody targeting interleukin-1 beta, indicated for cryopyrin-associated periodic syndromes (CAPS), familial Mediterranean fever, and acute gout attacks.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.