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2025 HCPCS code J7315

Mitomycin, ophthalmic, 0.2 mg

Use J7315 specifically for Mitosol; do not use it for compounded mitomycin or other forms of mitomycin. In the ASC setting, J7315 is bundled as a supply item and not separately reported.

The medical necessity for J7315 is established by the diagnosis of glaucoma requiring surgical intervention (trabeculectomy) and the use of mitomycin to prevent post-surgical complications such as scarring.

The ophthalmologist applies this antimetabolite topically to the eye during glaucoma filtration surgery.

IMPORTANT:Previously, unlisted drug code J3490 or sometimes J9280 (mitomycin, 5 mg) were used, although the latter's dosage didn't align with ophthalmic use. J9280's descriptor has since been modified.

In simple words: J7315 is a code for a drug called mitomycin, used in eye surgery to prevent scarring. It's applied to the surface of the eye during glaucoma surgery.

This code represents the supply of mitomycin, an ophthalmic drug, in a 0.2 mg dosage. It's used topically during glaucoma filtration surgery (trabeculectomy) to inhibit scar formation. Mitosol is a brand name for this drug supplied in individual vials containing 0.2 mg of lyophilized (dry) mitomycin. 1 ml of sterile water is added to reconstitute the drug to the proper concentration. In dry form, Mitosol is storable for up to two years; once reconstituted, it must be used within one hour.

Example 1: A patient undergoes a trabeculectomy for glaucoma. The ophthalmologist applies Mitosol (mitomycin) topically to the surgical site to prevent scarring and promote successful filtration., During a glaucoma surgery, the surgeon uses one vial of J7315 which represents 0.2mg of Mitosol., A patient with glaucoma requires a trabeculectomy and mitomycin is utilized to inhibit excessive scar tissue formation during the healing process. The surgeon uses a 0.2 mg dose of mitomycin opthalmic.

Documentation should include the diagnosis of glaucoma, the use of mitomycin during the trabeculectomy, the dosage administered (0.2 mg), and the NDC for Mitosol (49771-002-01).

** The National Drug Code (NDC) for Mitosol (0.2 mg) is 49771-002-01. As of Q1 2015, the Medicare allowed amount per vial was $372.80. Mitosol had "orphan drug" status when used in pterygium surgery.

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