J1670 Tetanus Immune Globulin Reimbursement | OpenPayer

Summary & Overview

HCPCS J1670: Injection, Tetanus Immune Globulin, Human, up to 250 Units

HCPCS Level II code J1670 denotes injection of human tetanus immune globulin up to 250 units, a passive immunization used to provide immediate protection against tetanus following potential exposure. Nationally, this product is clinically important in emergency and ambulatory settings to reduce the risk of tetanus in patients with contaminated wounds or unknown immunization status. Payers commonly cover this injectable under medical benefits when clinically indicated.

This analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical role, payer coverage context, and typical sites of service. The publication presents benchmark perspectives, common billing considerations, and any recent policy notices or coding guidance when available. It also clarifies where input data were not provided.

Intended for billing managers, revenue cycle teams, and clinical leaders, the piece explains how J1670 is billed in ambulatory and emergency settings and what information payers typically require for claim adjudication. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareJ1670HCPCS Level IItetanus immune globulininjectable therapypassive immunizationambulatory careemergency medicinemedical billing

Billing Code Overview

HCPCS Level II code J1670 represents Injection, tetanus immune globulin, human, up to 250 units. This code describes the provision of human tetanus immune globulin delivered by injection for passive immunization against tetanus.

Service type: Therapeutic injection / passive immunization
Typical site of service: Outpatient clinic, emergency department, urgent care, or other ambulatory settings for injectable treatments

Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, or detailed service line.

Clinical & Coding Specifications

Clinical Context

A 34-year-old adult presents to an urgent care clinic after sustaining a puncture wound from a rusty nail while gardening. The patient’s tetanus immunization history is uncertain and they have not received a tetanus toxoid-containing vaccine in the past five years. The clinician performs wound assessment, documents tetanus risk factors (e.g., contaminated wound, devitalized tissue), and determines passive immunization is indicated in addition to active immunization. Medication administration is ordered for tetanus immune globulin, human, up to 250 units (J1670). The drug is prepared by the clinic’s licensed nurse or pharmacist and administered via intramuscular injection in the deltoid or gluteal muscle depending on patient age and muscle mass. Vital signs and allergy status are confirmed before administration. The patient is observed for immediate adverse reactions for 15–30 minutes post-injection and given discharge instructions including follow-up for tetanus toxoid vaccination series and wound care. Documentation includes indication, lot number, units administered (capped at 250 units for J1670), route, site, consent, and any immediate adverse event.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no modifier applies and standard billing is appropriate.

HCPCS J0751: Emtricitabine 200mg / Tenofovir Alafenamide 25mg for HIV PrEP

HCPCS-J1956-LEVOFLOXACIN-INJECTION-250MG

HCPCS J1956: Injection, Levofloxacin 250 mg

HCPCS-J1600-GOLD-SODIUM-THIOMALATE-INJECTION-50MG

HCPCS Level II J1600: Injection, Gold Sodium Thiomalate, up to 50 mg

HCPCS-J7110-DEXTRAN-75-INFUSION-500ML

HCPCS J7110: Infusion, Dextran 75, 500 ml

HCPCS-J2503-PEGAPTANIB-SODIUM-INJECTION-0-3-MG

HCPCS J2503: Injection, pegaptanib sodium, 0.3 mg

HCPCS-J1817-INSULIN-FOR-INSULIN-PUMP-PER-50-UNITS

HCPCS Level II J1817: Insulin for Insulin Pump, per 50 Units

HCPCS-J8521-CAPECITABINE-ORAL-500MG

HCPCS J8521: Capecitabine, Oral, 500 mg

HCPCS-J1060-TESTOSTERONE-ESTRADIOL-INJECTION

HCPCS J1060: Testosterone Cypionate and Estradiol Cypionate Injection

HCPCS-J7638-DEXAMETHASONE-INHALATION-SOLUTION-COMPOUNDED-DME

HCPCS Level II J7638: Dexamethasone Inhalation Solution, Compounded

HCPCS-J0402-ARIPIPRAZOLE-INJECTION-1MG

HCPCS Level II J0402: Aripiprazole Injection, 1 mg

Showing 1–10 of 991

Taxonomy Code	Specialty	Notes
`207R00000X`	Family Medicine	Common clinicians in urgent care and primary care who assess wounds and administer `J1670`.
`207L00000X`	Emergency Medicine	Frequent site-of-service providers for acute wound management and tetanus immune globulin administration.
`163W00000X`	Nurse Practitioner	NPs in urgent care/clinic settings who may order and administer `J1670`.
`246Q00000X`	Physician Assistant	PAs who evaluate wounds and administer intramuscular immune globulin.
`207P00000X`	Internal Medicine	Hospital or clinic-based internists who may manage tetanus prophylaxis in adult patients.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`W25.0XXA`	Contact with sharp glass, initial encounter	Puncture wound indication prompting tetanus immune globulin for passive immunization.
`W29.0XXA`	Contact with nail, initial encounter	Specific code for nail puncture wounds — common scenario for tetanus exposure and `J1670` use.
`S91.309A`	Unspecified open wound, unspecified toe, initial encounter	Example of an open contaminated wound potentially requiring tetanus immune globulin.
`T88.1XXA`	Other complications following immunization, initial encounter	Used if the patient has an adverse reaction to prior vaccines that affects prophylaxis decisions.
`Z23`	Encounter for immunization	Administrative code used when administering a prophylactic immunoglobulin or vaccine during the encounter.
`A48.1`	Tetanus neonatorum	Represents tetanus-related conditions where immune globulin protocols differ; included for relevance to tetanus disease context.
`A35`	Neonatal tetanus	Clinical disease code relevant to tetanus management; passive immunization is part of broader tetanus care algorithms.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99202`	Office or other outpatient visit for the evaluation and management of a new patient, typically 15–29 minutes	E/M visit where wound assessment, decision to administer tetanus immune globulin (`J1670`), and documentation occur.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common visit code for follow-up or evaluation of a wound and administration of `J1670`.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Used to report the act of administering an IM injection of tetanus immune globulin when payer requires an administration code in addition to the drug J-code.
`80053`	Comprehensive metabolic panel	Laboratory tests commonly ordered if clinical status warrants baseline metabolic assessment prior to immunoglobulin in patients with comorbidities.
`99070`	Supplies and materials (e.g., syringes, gloves) used during patient care, over and above those usually included with the service	Used to report expendable supplies associated with drug preparation and administration if payer allows separate reporting.

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