Summary & Overview
HCPCS Level II J1990: Chlordiazepoxide Injection, Up to 100 mg
HCPCS Level II code J1990 denotes an injection of chlordiazepoxide hydrochloride, up to 100 mg. As an injectable benzodiazepine, this medication plays a role in managing acute alcohol withdrawal and certain severe anxiety presentations, making the code relevant across emergency, outpatient, and inpatient settings. Nationally, accurate coding for parenteral benzodiazepines affects medication utilization tracking, payer coverage determinations, and clinical quality measurement.
This analysis covers coverage and benchmark considerations for major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise policy and billing overview, common modifiers and billing practices, and clinical context explaining when J1990 is typically used. The publication also outlines typical sites of service, documentation elements tied to injectable medication claims, and how this code integrates with related service lines. Where input data was not provided, the report notes that information is unavailable.
Billing Code Overview
HCPCS Level II code J1990 represents an injection of chlordiazepoxide HCl, billed for doses up to 100 mg. This code covers the medication administration for chlordiazepoxide, a benzodiazepine commonly used for management of acute alcohol withdrawal symptoms and anxiety-related conditions.
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Service type: Medication injection
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Typical site of service: Outpatient clinic, emergency department, observation unit, or inpatient hospital setting where parenteral benzodiazepine administration is provided
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Clinical & Coding Specifications
Clinical Context
A patient presenting to an emergency department or outpatient detoxification clinic with acute alcohol withdrawal symptoms (anxiety, tremor, diaphoresis, insomnia, or potential for progression to delirium tremens) may receive a single parenteral dose of chlordiazepoxide. The typical workflow: triage and brief medical evaluation, review of substance use history and current medications, assessment of withdrawal severity (e.g., CIWA-Ar), informed consent for medication administration, documentation of vitals and allergies, preparation and administration of J1990 (Injection, chlordiazepoxide HCl, up to 100 mg) via intramuscular or intravenous route as ordered, post-injection monitoring for sedation, respiratory status, and hemodynamics, and recording of medication lot number and dosage in the medication administration record. Common settings include hospital emergency departments, detox units, observation units, and ambulatory surgical centers that manage acute withdrawal or pre-procedural anxiolysis when benzodiazepine administration is indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no special modifier applies to the service |
22 |