Summary & Overview
HCPCS J2760: Phentolamine Mesylate Injection, Up to 5 mg
HCPCS Level II code J2760 denotes the injectable drug phentolamine mesylate, supplied in amounts up to 5 mg. The code is used to report the medication itself in outpatient settings where parenteral agents are administered, including physician offices, outpatient clinics, and hospital outpatient departments. Nationally, accurate coding of drug J-codes like J2760 matters for proper claims processing, cost reporting, and clinical documentation tied to pharmacologic interventions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns and coding considerations for HCPCS Level II drug reporting, benchmarking context for utilization and reimbursement where available, and clinical context that explains typical use cases for phentolamine mesylate injections. The publication summarizes common billing modifiers used with J-codes, typical sites of service, and notes where input data was not provided.
This summary equips billing managers, revenue cycle analysts, and policy professionals with the essential facts about HCPCS Level II code J2760, helping stakeholders align documentation and claim submission practices with payer expectations and national billing norms.
Billing Code Overview
HCPCS Level II code J2760 represents the medication phentolamine mesylate, supplied as an injection in doses up to 5 mg. This code is used to report the administration or supply of the drug product itself rather than the evaluation or procedural services surrounding its use.
Service Type: Drug injection / parenteral drug administration
Typical Site of Service: Outpatient clinic, physician office, or hospital outpatient setting, where injectable pharmacologic agents are administered for diagnostic or therapeutic purposes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who has received a local injection of a vasoconstrictive agent (for example, epinephrine) or experienced a local extravasation of a vasoactive drug leading to prolonged local vasospasm or ischemia. The patient presents to an outpatient clinic, urgent care, emergency department, or procedure suite with persistent localized ischemic signs such as intense pain, pallor, decreased capillary refill, or dusky coloration at an injection site or digit. After assessment, the clinician prepares and administers J2760 (phentolamine mesylate, up to 5 mg) via local infiltration around the affected area to produce alpha-adrenergic blockade and reverse vasoconstriction. Typical workflow: evaluate vascular status and neurovascular checks; obtain informed consent; document indication, dose, lot number, and route; prepare and reconstitute phentolamine as needed; inject locally around the area of vasospasm; monitor for reperfusion and adverse effects; perform repeat assessments and document outcomes. Usual sites of service include outpatient clinic, urgent care, emergency department, and ambulatory procedure areas.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Principal procedure | When J2760 is the primary service performed during the encounter |