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    HCPCS Details

    HCPC J0642
    Short Description Injection, khapzory, 0.5 mg
    Long Description Injection, levoleucovorin (khapzory), 0.5 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1E
    Action code P
    Type of service 1
    Effective date 2024-01-01
    Date Added 2019-10-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    68152011201 J0642 Injection, khapzory, 0.5 mg Khapzory SPECTRUM PHARMACEUTICALS 0.5 MG 1 1 350 350
    68152011401 J0642 Injection, khapzory, 0.5 mg Khapzory SPECTRUM PHARMACEUTICALS 0.5 MG 1 1 600 600
    72893000401 J0642 Injection, khapzory, 0.5 mg Khapzory ACROTECH BIOPHARMA 0.5 MG 1 1 350 350
    72893000601 J0642 Injection, khapzory, 0.5 mg Khapzory ACROTECH BIOPHARMA 0.5 MG 1 1 600 600
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    Drug Details

    • Levoleucovorin injection is used in adults and children to prevent harmful effects of methotrexate (Trexall) when methotrexate is used to treat osteosarcoma (cancer that forms in bones). Levoleucovorin injection is also used to treat adults and children who have accidentally received an overdose of methotrexate or similar medications or who are not able to eliminate these medications properly from their bodies. Levoleucovorin injection is also used with fluorouracil (5-FU, a chemotherapy medication) to treat adults with colorectal cancer (cancer that begins in the large intestine) that has spread to other parts of the body. Levoleucovorin injection is in a class of medications called folic acid analogs. It works to prevent the harmful effects of methotrexate by protecting healthy cells, while allowing methotrexate to enter and kill cancer cells. It works to treat colorectal cancer by increasing the effects of fluorouracil.