Summary & Overview
HCPCS J1245: Injection, Dipyridamole, per 10 mg
HCPCS Level II code J1245 represents the injectable formulation of dipyridamole billed per 10 mg. Nationally, this code is used to capture the cost and administration of dipyridamole when delivered via injection in outpatient infusion settings, hospital outpatient departments, or physician offices. Accurate use of J1245 is important for tracking pharmaceutical utilization, facility billing, and payer coverage determinations for antiplatelet or vasodilatory therapy.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for injectable dipyridamole, standard settings of administration, common billing considerations, and the payer landscape relevant to reimbursement and coverage policies. The publication provides benchmarks where available, summarizes recent policy updates affecting injectable drug billing, and outlines coding and service-line implications for revenue cycle and clinical teams.
Data not available in the input includes specific associated taxonomies, ICD-10 diagnoses linked to J1245, and related billing codes. Those sections are noted as unavailable where applicable.
Billing Code Overview
HCPCS Level II code J1245 describes an injection of dipyridamole, billed per 10 mg unit. The service represents administration of dipyridamole as an injectable pharmaceutical agent.
Service type: Therapeutic injection / drug administration
Typical site of service: Outpatient infusion clinic, hospital outpatient department, or physician office
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult outpatient referred to a cardiology clinic for pharmacologic stress testing due to chest pain or an abnormal exercise tolerance test. The patient has limited exercise capacity because of musculoskeletal limitation or deconditioning. The clinic schedules a pharmacologic stress myocardial perfusion imaging study. During the procedure, the nuclear medicine technologist or registered nurse prepares and administers intravenous J1245 (dipyridamole) in 10 mg increments as the vasodilator agent to induce coronary vasodilation. Vital signs and continuous ECG monitoring are performed before, during, and after administration. If imaging requires adjunctive agents or reversal of effects, aminophylline may be given. Documentation includes the amount of J1245 billed per 10 mg unit, indication for stress testing, patient consent, hemodynamic response, any adverse reactions, and time-stamped administration records. Typical sites of service are hospital outpatient departments, freestanding imaging centers, and cardiology clinics with nuclear medicine capability.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default billing | Used when no special circumstances apply. |