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Stelara (J3358) HCPCS Code: 2026 Billing & ICD-10 Requirements

Last Updated: September 12, 2026

Stelara (ustekinumab) is a high-cost biologic billed under J3358 ↗ for subcutaneous injections. Accuracy in your 2026 unit calculation and diagnosis linking is essential to prevent costly claim denials.

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Unit Calculation for Stelara (J3358)

The HCPCS code J3358 ↗ is defined as "Ustekinumab, for subcutaneous injection, 1 mg".

If a patient is administered a standard 90 mg subcutaneous dose for Crohn's disease, you must bill 90 units.

DrugCodeAdministered DosageBilling Units
Stelara (SubQ)J335890 mg90

Note: If administering Stelara intravenously (IV) for an induction dose, use the separate code J3357 ↗.

Medical Necessity: ICD-10 Linkage

Verify Medical Necessity

Don't risk a denial. See if your ICD-10 code is on the approved Medicare LCD list.

Medicare and commercial payers require strict Medical Necessity documentation. Approved diagnoses usually include:

Administration Edits

For subcutaneous Stelara (J3358), bill the administration code 96372 ↗. Ensure your NCCI edit checks are clear if you are billing a concurrent Evaluation and Management (E/M) visit.

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