Summary & Overview
HCPCS J2354: Octreotide 25 mcg Injection, Non-Depot
HCPCS Level II code J2354 identifies a 25 mcg vial of octreotide in its non-depot formulation for subcutaneous or intravenous injection. Octreotide is used in clinical practice for managing certain hormone-secreting tumors and complications such as acute variceal bleeding; the non-depot form is typically used for short-term or inpatient/outpatient acute management where rapid onset and flexible dosing are needed. Nationally, this billing code matters because it specifies a drug product and route that influence drug billing, site-of-service charging, and payer coverage policies.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, common sites of service, and what to expect in payer coverage considerations. The publication outlines benchmarking and reimbursement context where available, highlights relevant clinical contexts for non-depot octreotide use, and notes common billing modifiers and administrative factors when present in the input.
This summary is intended for revenue cycle managers, coding professionals, and clinical administrators seeking a national-level reference for HCPCS Level II code J2354. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J2354 represents an injection of octreotide, non-depot form, formulated for subcutaneous or intravenous administration, dosed at 25 mcg. This code describes the medication product and route of administration rather than the clinical indication.
Service type: Medication administration (injectable drug)
Typical site of service: Outpatient clinic, physician office, or hospital outpatient department
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with symptomatic carcinoid syndrome secondary to metastatic neuroendocrine tumor presents to an outpatient infusion clinic for scheduled short-acting octreotide therapy. The provider orders J2354 for subcutaneous injection of octreotide 25 mcg due to breakthrough flushing and diarrhea despite maintenance long-acting depot therapy or because rapid symptom control is needed prior to long-acting formulation initiation. The clinical workflow includes verification of the order, allergy and medication reconciliation, obtaining informed consent for injection, preparation of the non-depot octreotide vial or syringe by pharmacy or nursing, performance of standard infection control and injection-site assessment, administration of the subcutaneous (or less commonly intravenous) injection, 15–30 minutes of post-injection observation for adverse effects (bradycardia, blood glucose changes), documentation of dose, lot number, site, and patient response, and billing using J2354 with appropriate modifier(s) and the primary ICD-10 diagnosis documenting the indication for therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used / default | Applied when no specific modifier is applicable to the service. |