Summary & Overview
HCPCS J0500: Injection, Dicyclomine HCl up to 20 mg
HCPCS Level II code J0500 denotes an injection of dicyclomine hydrochloride, up to 20 mg, used to relieve gastrointestinal smooth muscle spasms. This code identifies a single-dose parenteral medication administration and is relevant across ambulatory and outpatient care settings. Nationally, accurate use of J0500 matters for correct drug utilization tracking, billing compliance, and clinical reporting for treatments of functional bowel disorders and spasm-related abdominal pain.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of dicyclomine injection, typical sites of service, and payer coverage considerations. The publication summarizes benchmarking elements and common billing considerations for injectable medications where available, highlights coding clarity for J0500, and notes where data is not available in the input.
This summary is intended for national audiences including revenue cycle professionals, clinicians involved in procedural medication administration, and policy analysts seeking a clear reference for the HCPCS Level II code J0500.
Billing Code Overview
HCPCS Level II code J0500 represents an injection of dicyclomine hydrochloride, dosed up to 20 mg. The service involves administration of an anticholinergic medication commonly used to relieve smooth muscle spasms in the gastrointestinal tract.
Service type: Parenteral medication administration (single injectable drug dose).
Typical site of service: Ambulatory clinic, physician office, urgent care, or hospital outpatient setting where injectable medications are administered.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an urgent care clinic or emergency department with acute cramping abdominal pain, spasms, or hypermotility consistent with irritable bowel syndrome (IBS), gastroenteritis, or biliary colic where anticholinergic therapy is indicated. The clinician evaluates history and physical exam, documents indications and contraindications (glaucoma, obstructive GI disease, urinary retention, myasthenia gravis), obtains informed consent for parenteral medication, and orders J0500 (injection, dicyclomine HCl, up to 20 mg). A nurse or licensed clinician prepares the intramuscular injection, documents lot number, dose, route (IM), site of administration, and any immediate adverse effects. The provider documents medical necessity, time and date of administration, and links the service to the appropriate ICD-10 diagnosis. Follow-up instructions and symptomatic relief assessment are recorded prior to discharge or observation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of procedure | Use when an E/M visit is performed and documented separately from the injection visit for the same patient on the same date |