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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j2690-procainamide-injection-1g
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    HCPCS Level II J2690: Injection, procainamide HCl, up to 1 gm

    HCPCS Level II code J2690 describes the drug supply for an injection of procainamide hydrochloride, up to 1 gram, used for antiarrhythmic therapy; the service type is drug administration and the typical site of service is hospital inpatient or outpatient infusion/clinic setting where parenteral antiarrhythmic agents are administered.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult presenting to the emergency department or inpatient unit with symptomatic ventricular arrhythmia (for example, sustained ventricular tachycardia) or life-threatening supraventricular arrhythmias unresponsive to first-line therapy. The cardiology team evaluates rhythm strips, vital signs, electrolytes, and drug history. After indication is confirmed and contraindications (e.g., advanced heart block without pacemaker, allergy to procainamide) are excluded, the provider orders intravenous procainamide for acute arrhythmia suppression. Medication is prepared in pharmacy or at bedside, weight-based dosing is confirmed, and continuous cardiac monitoring is initiated. The drug is administered as an intravenous injection or infusion per institutional protocol with frequent ECG and hemodynamic monitoring; dose adjustments or discontinuation occur for hypotension, QRS widening, or arrhythmia termination. Documentation includes indication, informed consent when required, exact dose (J2690 describes up to 1 gm), route, time, patient response, monitoring data, and any adverse events. Typical sites of service are emergency department, inpatient ward, or monitored procedure areas within hospitals.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    93000Electrocardiogram, routine ECG with at least 12 leads; with interpretation and reportPerformed before and after procainamide administration to document baseline rhythm and response.
    92950Cardiopulmonary resuscitation (adult)May be performed if arrhythmia progresses to cardiac arrest despite antiarrhythmic therapy.
    92960Cardioversion, elective or emergency, externalSynchronized electrical cardioversion may be performed if procainamide is ineffective or not indicated.
    36556Insertion of non-tunneled centrally inserted central venous catheter (e.g., for medication administration)Used when central access is required for drug administration or hemodynamic monitoring in unstable patients.
    93229External electrocardiographic monitoring of arrhythmia; single or multiple lead with patient-connected recording device (e.g., telemetry)Continuous telemetry monitoring CPT codes may be billed for prolonged cardiac monitoring associated with administration and observation.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    364S00000XClinical Nurse SpecialistA registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
    246ZG0701XGraphics Methods Specialist/TechnologistNone
    163WC0400XCase Management Registered NurseNursing Service Providers · Registered Nurse
    246XC2903XVascular Specialist/Technologist CardiovascularA vascular technologist, also known as a vascular sonographer, creates images of blood vessels and collects data that help physicians diagnose disorde…
    156FX1100XOphthalmic Technician/TechnologistAn ophthalmic technician/technologist assists ophthalmologists by performing ophthalmic clinical functions, including administering eye exams, adminis…
    207WX0009XGlaucoma Specialist (Ophthalmology) PhysicianAn ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. …

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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