2025 HCPCS code J0171
Effective Date: N/A Drugs Administered by Injection Feed
Injection, adrenalin, epinephrine, 0.1mg.
Modifiers may be applicable depending on the payer and specific circumstances of the administration.
Medical necessity for epinephrine is established by the presence of a severe allergic reaction or other condition requiring immediate vasoconstriction and bronchodilation. Supporting documentation should clearly establish this condition.
The healthcare provider is responsible for administering the epinephrine injection correctly and monitoring the patient's response.
In simple words: This code covers the epinephrine injection a healthcare professional gives you for a severe allergic reaction, insect bites, or very low blood pressure. It's for 0.1 milligrams given as a shot into a muscle or under the skin.
Adrenalin (epinephrine) is used to treat severe allergic reactions, constrict blood vessels, and open airways. This code represents one unit of 0.1 mg of adrenalin administered by intramuscular (IM) or subcutaneous (Subcu) injection.
Example 1: A patient presents to the emergency room with anaphylaxis after a bee sting. The physician administers epinephrine IM, and code J0171 is reported., A child experiences an allergic reaction to peanuts at school. The school nurse administers an epinephrine injection subcutaneously, using code J0171., During surgery, a patient's blood pressure drops dangerously low. The anesthesiologist administers epinephrine to stabilize the blood pressure, and J0171 is reported.
Documentation should include the dosage administered, the route of administration (IM or Subcu), the diagnosis necessitating the injection (e.g., anaphylaxis, allergic reaction), and the patient's response to treatment.
** Brand names for epinephrine include EpiPen, Adrenaclick, and Auvi-Q. J0171 is used for professionally administered epinephrine, not for auto-injectors prescribed for personal use.
- Specialties:Emergency Medicine, Allergy and Immunology, Anesthesiology, Pediatrics
- Place of Service:Office, Hospital, Emergency Room - Hospital, Ambulatory Surgical Center, Federally Qualified Health Center, School