J0752 Hiv prep, oral lenacapavir
Also known as: Lenacapavir PrEP, oral lenacapavir
Lenacapavir oral capsule, a capsid inhibitor for Human Immunodeficiency Virus pre-exposure prophylaxis with long-acting pharmacokinetics allowing infrequent dosing.
In Plain Language
Long-acting HIV prevention pill; Extended-interval HIV prevention
Clinical Context
Used for pre-exposure prophylaxis in individuals with high Human Immunodeficiency Virus acquisition risk, offering improved adherence due to extended dosing intervals with novel mechanism of action.
RVU Information
CPT J0752 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 J0752?
CPT J0752 (Hiv prep, oral lenacapavir) is a J Codes (Drugs) code. Lenacapavir oral capsule, a capsid inhibitor for Human Immunodeficiency Virus pre-exposure prophylaxis with long-acting pharmacokinetics allowing infrequent dosing.
How is J0752 administered?
CPT J0752 is administered by a healthcare provider, typically via injection or infusion. Used for pre-exposure prophylaxis in individuals with high Human Immunodeficiency Virus acquisition risk, offering improved adherence due to extended dosing intervals with novel mechanism of action. It is used by Infectious Disease, Public Health, Internal Medicine.
When is CPT J0752 used?
Used for pre-exposure prophylaxis in individuals with high Human Immunodeficiency Virus acquisition risk, offering improved adherence due to extended dosing intervals with novel mechanism of action.
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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.