Start New EnglishEspañol中文РусскийالعربيةTiếng ViệtFrançaisDeutsch한국어Tagalog Library Performance

2025 HCPCS code J0751

200 mg emtricitabine and 25 mg tenofovir alafenamide oral dose for HIV pre-exposure prophylaxis (PrEP).

Follow all FDA and CDC guidelines regarding PrEP prescription and administration.

Medical necessity for J0751 is established by the patient's risk factors for HIV acquisition, such as multiple partners, inconsistent condom use, or a partner with HIV.The code should align with guidelines from the CDC and FDA for PrEP use.

Prescribing and monitoring the patient's use of PrEP, including assessment of risk factors, adherence counseling, and regular testing for HIV and other sexually transmitted infections (STIs).

In simple words: This code is for a pill containing two medicines (emtricitabine and tenofovir alafenamide) used to prevent HIV infection in people at high risk but who don't have HIV yet.The pill helps stop HIV from taking hold if someone is exposed to it.

This HCPCS code, J0751, represents a single oral dose of 200 mg emtricitabine and 25 mg tenofovir alafenamide, administered for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP).Emtricitabine and tenofovir alafenamide are available in tablet form, with each tablet containing the specified dosage.This code's use is specific to FDA-approved PrEP for individuals at substantial risk of HIV infection but not currently infected.PrEP aims to prevent HIV infection by interfering with viral establishment after potential exposure. Report this code for each oral dose administered.

Example 1: A 28-year-old male patient at high risk for HIV infection due to multiple sexual partners initiates PrEP.J0751 is reported for each daily dose of the medication., A 35-year-old female patient in a serodiscordant relationship (one partner HIV-positive, one negative) is prescribed PrEP. J0751 is billed for each prescribed oral dose., A healthcare provider prescribes PrEP for a 40-year-old transgender woman who engages in high-risk sexual behavior.J0751 is used to bill for the medication given at each visit.

* Patient's medical history indicating risk factors for HIV infection.* Documentation of informed consent for PrEP.* Prescribing physician's order specifying dosage and frequency.* Evidence of regular HIV and STI testing.* Documentation of adherence counseling and strategies.

** The brand name for this drug is Descovy®.Always verify that the medication dispensed matches the code reported.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

Discover what matters.

iFrame™ AI's knowledge is aligned with and limited to the materials uploaded by users and should not be interpreted as medical, legal, or any other form of advice by iFrame™.