J1726 Makena, 10 milligrams
Also known as: Makena, hydroxyprogesterone caproate
Makena (hydroxyprogesterone caproate) injection, 10 milligrams. A progestin for preterm birth prevention in high-risk pregnancies.
In Plain Language
preterm birth prevention; pregnancy hormone injection
Clinical Context
Used for prevention of preterm birth in women with singleton pregnancy and history of prior preterm birth. Weekly intramuscular injections from 16-36 weeks gestation.
RVU Information
CPT J1726 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 J1726?
CPT J1726 (Makena, 10 milligrams) is a J Codes (Drugs) code. Makena (hydroxyprogesterone caproate) injection, 10 milligrams. A progestin for preterm birth prevention in high-risk pregnancies.
How is J1726 administered?
CPT J1726 is administered by a healthcare provider, typically via injection or infusion. Used for prevention of preterm birth in women with singleton pregnancy and history of prior preterm birth. Weekly intramuscular injections from 16-36 weeks gestation. It is used by OB/GYN, Maternal-Fetal Medicine, Internal Medicine.
When is CPT J1726 used?
Used for prevention of preterm birth in women with singleton pregnancy and history of prior preterm birth. Weekly intramuscular injections from 16-36 weeks gestation.
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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.