Summary & Overview
HCPCS J1430: Ethanolamine Oleate Injection, 100 mg
HCPCS Level II code J1430 denotes an injection of ethanolamine oleate, 100 mg, a sclerosant used in targeted local injectable treatments. Nationally, this code is relevant for clinicians, payers, and billing teams managing claims for sclerotherapy and related outpatient procedures that employ ethanolamine oleate. Accurate coding affects claim adjudication, site-of-service classification, and pharmacy billing workflows.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of how J1430 is used clinically, common sites of service, and the payer landscape that matters for coverage and reimbursement patterns. The publication outlines typical billing considerations, common modifiers referenced in payer communications, and where to look for policy guidance.
This summary provides benchmarks and policy context useful for revenue cycle and clinical compliance teams: how J1430 is positioned among injectable therapeutics, practical coding notes for outpatient administration, and expectations around payer coverage variability. Data not available in the input is noted where applicable, and readers will gain a clear, national-level overview of the clinical and billing implications of HCPCS Level II code J1430.
Billing Code Overview
HCPCS Level II code J1430 represents an injection of ethanolamine oleate, 100 mg. This medication is supplied for sclerotherapy procedures and other treatments that require local injection of a sclerosant agent. The service type is an injectable pharmacologic treatment administered by a clinician.
The typical site of service for administration of J1430 is outpatient settings such as physician offices, ambulatory surgical centers, and hospital outpatient departments where injectable sclerosants are given for targeted local therapy.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient vascular clinic or interventional radiology suite with symptomatic small variceal or telangiectatic lesions, sclerosing of small esophageal varices, or venous malformations appropriate for chemical sclerotherapy. The patient often reports localized pain, swelling, or recurrent bleeding from superficial varicosities or small vascular malformations unresponsive to conservative measures. Pre-procedure evaluation includes history, focused vascular or GI exam, informed consent, and review of anticoagulation status.
The clinical workflow: the patient arrives to an ambulatory infusion or procedure room (office-based procedure, outpatient hospital outpatient department, or ambulatory surgery center). Baseline vital signs and pertinent labs are reviewed. Local anesthesia or conscious sedation may be used per provider preference. Under ultrasound or endoscopic guidance when applicable, the provider injects J1430 (ethanolamine oleate, 100 mg) into the targeted lesion. Post-injection monitoring for immediate complications (allergic reaction, pain, tissue necrosis, thrombosis) occurs and discharge instructions are given for wound care and signs of complications. Follow-up visits evaluate clinical response and determine need for repeat sclerotherapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |