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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0164-epinephrine-in-sodium-chloride-injection-0-1-mg
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    HCPCS Level II J0164: Epinephrine Injection 0.1 mg

    HCPCS Level II code J0164 describes a 0.1 mg injection of epinephrine in sodium chloride (Baxter) intended for parenteral administration; the service is an epinephrine injection used for emergent treatment of severe allergic reactions and anaphylaxis and is typically administered as an intramuscular or subcutaneous injection in emergency department, urgent care, or clinic settings.

    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 typical patient is an adult or pediatric emergency department patient presenting with anaphylaxis, severe allergic reaction, or acute bronchospasm refractory to inhaled therapy. The clinician administers a pre-diluted epinephrine injection in sodium chloride (0.1 mg) via intramuscular or subcutaneous route to promptly reverse hypotension, bronchospasm, laryngeal edema, or urticaria. The workflow includes rapid triage recognition of anaphylaxis, preparation and labeling of the J0164 vial or syringe, verification of patient identity and allergies, administration of the indicated dose, monitoring of vital signs and cardiac rhythm, documentation of indications and response, and disposition planning (observation, admission, or discharge with epinephrine autoinjector prescription and patient education). Typical sites of service are the emergency department, urgent care, inpatient hospital unit, and ambulance/prehospital settings where injectable epinephrine is required immediately.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96372Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)Commonly billed for the act of administering an injectable medication such as J0164 when payer policy requires a separate administration code.
    J0171Injection, epinephrine, single dose (0.3 mg) — HCPCS example code for alternate strengthClinically related as an alternative epinephrine product/strength used for anaphylaxis; useful for workflow comparison though not the same HCPCS as J0164.
    99283Emergency department visit, moderate severityTypical ED E/M level for a patient treated for anaphylaxis who requires medication administration and monitoring.
    99464Attendance at delivery — initial stabilization of the newborn (not usually applicable)Data not typically applicable; included only when neonatal resuscitation involves epinephrine administration in delivery settings.
    94010Bronchospasm evaluation (spirometry)May be performed before/after medication administration in patients with acute asthma exacerbation to document response.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    2080P0205XPediatric Endocrinology PhysicianA pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands…
    103TR0400XRehabilitation PsychologistA psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illn…
    207UN0902XNuclear Imaging & Therapy PhysicianA nuclear medicine physician who specializes in nuclear imaging and therapy.
    213ES0103XFoot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers · Podiatrist
    225A00000XMusic TherapistMusic therapists use music interventions to assess clients' strengths and needs, develop goals, implement services, and evaluate and document progress…

    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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