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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0162-epinephrine-fresenius-0-1-mg-injection
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    HCPCS Level II J0162: Epinephrine (Fresenius) Injection 0.1 mg

    HCPCS Level II code J0162 describes a 0.1 mg injection of epinephrine (Fresenius) identified as not therapeutically equivalent to J0165; the service is an epinephrine injectable product provided as a drug administration event, typically delivered in outpatient clinic or facility medication administration settings such as ambulatory infusion centers or hospital outpatient departments. Data not available in the input.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays.

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    Clinical & Coding Specifications

    Clinical Context

    A child or adult presents to an outpatient clinic, urgent care, emergency department, or physician office with an acute anaphylactic reaction or high-risk allergic exposure (for example, after insect sting, food ingestion, medication exposure, or severe allergic rhinitis with respiratory compromise). The clinician evaluates airway, breathing, circulation and documents signs such as hives, angioedema, bronchospasm, stridor, hypotension, or altered mental status. When immediate intramuscular epinephrine is indicated, a clinician or trained staff prepares a 0.1 mg dose of epinephrine (compound vial labeled as fresenius, not therapeutically equivalent to J0165) and administers via intramuscular injection (typically mid-anterolateral thigh). Vital signs and response to medication are monitored, and additional emergency treatments (oxygen, nebulized bronchodilator, intravenous fluids, antihistamines, corticosteroids) are provided as clinically indicated. The medication administration, drug lot, concentration, route, site, and patient response are documented in the medical record. Typical sites of service include ambulatory clinic, urgent care center, emergency department, and physician office immunology/allergy or primary care visits where acute allergic reactions are treated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularCommonly billed for single intramuscular epinephrine injections when facility billing does not separately bill the drug HCPCS; used in outpatient/office settings.
    99202Office or other outpatient visit for the evaluation and management of a new patient, typically 20 minutesBilled when a new patient presents with an allergic reaction and an E/M visit is documented along with the injection (25 modifier may be required).
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesBilled for evaluation and management of an established patient receiving epinephrine in an office visit when documentation supports the E/M level.
    94640Pressurized or non-pressurized inhalation treatment for acute airway obstruction (e.g., inhaled bronchodilator)Often performed alongside epinephrine for bronchospasm as part of emergency management.
    99199Unlisted special service, procedure or reportUsed only if a specific procedure related to administration or specialized drug preparation is not described by existing CPT codes; use sparingly per payer rules.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    97Modifier 97 is an informational modifier used with therapy CPT codes to indicate services are rehabilitative — intended to restore skills or function lost due to illness, injury, or disability. It is…- Use modifier 97 when reporting therapy services that are rehabilitative in nature — i.e., provided to restore skills or function lost or impaired because of illness, injury, or disability (for…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    376J00000XHomemakerAn individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly respo…
    293D00000XPhysiological LaboratoryA laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans,…
    207X00000XOrthopaedic Surgery PhysicianAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E86.0Dehydration
    I10Essential (primary) hypertension
    J45.901Unspecified asthma with (acute) exacerbation
    J45.909Unspecified asthma, uncomplicated
    J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
    J96.02Acute respiratory failure with hypercapnia
    L50.0Allergic urticaria
    L50.1Idiopathic urticaria
    L50.9Urticaria, unspecified
    R06.02Shortness of breath

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    1 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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