Summary & Overview
HCPCS J1890: Injection, Cephalothin Sodium, up to 1 Gram
HCPCS Level II code J1890 denotes injection of cephalothin sodium, up to 1 gram. As a code for a commonly used parenteral first-generation cephalosporin, it matters nationally for hospital and outpatient pharmacy billing, antibiotic stewardship tracking, and inpatient antimicrobial cost management. The code captures single-dose administration events and is used across acute and ambulatory settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for cephalothin injection, typical sites of service, and which payers commonly process claims with this code. The publication summarizes available benchmarks and reimbursement considerations, highlights relevant billing practice factors, and outlines policy updates that affect coverage and coding for injectable antibiotics. It also provides practical detail on where J1890 fits within service lines and why accurate use matters for claims processing, pharmacy inventory, and quality measurement.
This national-level summary is intended for billing managers, clinical pharmacists, revenue cycle professionals, and policy analysts seeking a clear reference for HCPCS Level II code J1890 and its role in billing for injectable cephalothin.
Billing Code Overview
HCPCS Level II code J1890 represents Injection, cephalothin sodium, up to 1 gram. This code describes a single dose of the first-generation cephalosporin antibiotic cephalothin, provided as an injectable medication.
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Service type: Parenteral antibiotic therapy (intravenous or intramuscular injection)
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Typical site of service: Hospital inpatient, hospital outpatient, emergency department, ambulatory surgical center, or other outpatient clinic settings where injectable antibiotics are administered
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male presenting to an urgent care or hospital outpatient clinic with acute signs of a suspected gram-positive bacterial infection following a surgical wound infection or cellulitis unresponsive to oral antibiotics. The clinician assesses vital signs, reviews allergy history (notably beta-lactam allergies), and orders parenteral antibiotic therapy. In the clinic or infusion suite, nursing prepares and administers J1890 (injection, cephalothin sodium, up to 1 gram) via intramuscular or intravenous push/infusion per facility protocol. Documentation includes indication, dose administered, lot number, route, injection site, patient tolerance, and any immediate adverse reactions. Follow-up orders may include repeat dosing intervals, wound cultures, or escalation to broader-spectrum IV antibiotics if clinical response is inadequate. Typical sites of service are outpatient clinic, hospital outpatient department, emergency department, or skilled nursing facility where parenteral antibiotic administration is performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when administration requires substantially greater resources than usual, documented with justification. |