2025 HCPCS code J2354
(Active) Effective Date: N/A Drugs Administered Other than Oral Method - Drugs, Administered by Injection Feed
Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg.
Modifiers may be applicable depending on the specific circumstances of administration and payer guidelines.
Medical necessity for octreotide must be supported by documentation of a diagnosed condition for which it is an indicated treatment, such as acromegaly, carcinoid syndrome, or VIPoma, along with evidence of symptoms requiring intervention.
The provider is responsible for selecting the appropriate form and dosage of octreotide based on the patient's diagnosis and condition. They must also monitor the patient for potential side effects and adjust treatment as needed.
In simple words: Octreotide is a man-made protein used to treat various conditions. It works by reducing levels of certain substances in the body, such as insulin, glucagon, growth hormone, and chemicals affecting digestion. It is used to treat conditions like acromegaly (overgrowth of body tissues) and diarrhea caused by cancerous colon tumors. This code is for 25 micrograms of octreotide, specifically the type that's not a depot injection (long-acting). It only covers the medication itself, not the act of administering it.
Octreotide is a synthetic protein that has the same properties as the hormone somatostatin in the body. One unit of this code represents 25 mcg of octreotide. Routes of administration include subcutaneous, which is an injection under the skin, and intravenous, which is an injection, or instillation of liquid, through a needle into a vein. This code represents the nondepot form of octreotide.
Example 1: A patient with acromegaly receives a subcutaneous injection of octreotide (J2354) to control growth hormone levels., A patient with a carcinoid tumor causing severe diarrhea is given intravenous octreotide (J2354) to alleviate symptoms., A patient with a VIPoma (tumor secreting vasoactive intestinal peptide) receives octreotide (J2354) to manage watery diarrhea and electrolyte imbalances.
Documentation should include the diagnosis, the dosage and route of administration of octreotide, and any relevant lab results or imaging studies.
** This is a generic drug. Brand names include Sandostatin®. This J-code represents a drug that generally cannot be self-administered.
- Specialties:Endocrinology, Oncology, Gastroenterology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital