Summary & Overview
HCPCS Level II J0470: Dimercaprol Injection, per 100 mg
HCPCS Level II code J0470 denotes the injection of dimercaprol billed per 100 mg, capturing the parenteral administration of an antidotal chelating agent used in acute heavy metal poisoning. Nationally, this code matters for hospitals and acute care facilities that provide emergent toxicology treatments, as appropriate coding affects medication tracking, clinical documentation, and payer reimbursement pathways. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what J0470 represents clinically and operationally, typical sites of service, common payer considerations, and areas where policy updates or billing guidance can affect claims processing for antidotal therapies. The publication highlights benchmarks where available, summarizes payer coverage patterns and coverage considerations at a national level, and provides clinical context for when dimercaprol is used. Data elements such as specific associated taxonomies, ICD-10 diagnoses, and related procedure codes are noted where available; if not present in the input, those fields are identified as not provided. This summary is intended to orient coders, billing managers, and clinical administrators on the role of J0470 in toxicology care and revenue cycle workflows.
Billing Code Overview
HCPCS Level II code J0470 represents an injection of dimercaprol, billed per 100 mg. The service is a parenteral antidote/chelation therapy used for the treatment of heavy metal poisoning (e.g., arsenic, gold, mercury). The service type is injectable medication administration. The typical site of service is hospital inpatient, hospital outpatient, or other acute care settings where parenteral antidote therapy is provided.
Clinical & Coding Specifications
Clinical Context
A patient presents to an emergency department or inpatient setting with suspected heavy metal poisoning (for example, acute arsenic, mercury, or gold exposure) or a patient develops severe adverse effects from metal-based antidotes requiring chelation. The clinical workflow begins with urgent toxicology evaluation, including history of exposure, physical exam, and laboratory testing (blood metals, renal and hepatic panels). On determination that intramuscular dimercaprol is indicated, orders are placed for J0470 (Injection, dimercaprol, per 100 mg). Nursing prepares the medication per institutional protocol, confirms informed consent when feasible, and administers deep intramuscular injections (typically in the gluteal region) with monitoring for pain, hypertension, tachycardia, fever, or allergic reaction. Vital signs and local injection site are monitored post-dose. Documentation includes indication, dose in mg and number of 100 mg units billed, medication lot number, site of injection, patient tolerance, and any immediate adverse events. Subsequent chelation therapy (e.g., oral chelators or continued parenteral therapy) and serial metal level monitoring guide further dosing and additional administrations of J0470.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |