HCPCS Level II › J codes J7635 Atropine comp conAtropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 0 units per day (clinical), rationale: Compounded Drug Policy Outpatient hospital: max 0 units per day (clinical), rationale: Compounded Drug Policy DME supplier: max 0 units per day (clinical), rationale: Compounded Drug Policy Medicare pricing for J7635 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J7635 Payer coverage policies that name J7635 J7635 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Nebulizers (0065) covered if criteria are met Mar 18, 2026 payer document Aetna Omalizumab (0670) listed, no stance Aug 21, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN.
OH: $0.16 (provider_administered_drugs), effective Apr 1, 2006 VA: $0.12 (medical), effective Jan 1, 2006 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $0.12 (professional_administered_drugs), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.