Summary & Overview
HCPCS Level II J2940: Injection, Somatrem, 1 mg
HCPCS Level II code J2940 denotes a 1 mg dose of somatrem administered as an injectable therapeutic agent. Somatrem is an engineered growth hormone preparation used in clinical practice for growth hormone replacement and related indications; accurate coding of J2940 is important for correct billing, inventory tracking, and claims adjudication at the national level. This brief covers standard clinical context, common sites of service, and payer coverage considerations for commercially insured and government payers.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what J2940 represents, typical service delivery settings, and which payers are relevant to reimbursement discussions. The publication outlines what users can expect regarding benchmark and policy-oriented content: payer coverage patterns, reimbursement benchmarks where available, and clinical context that informs utilization.
This summary is designed for billing professionals, practice administrators, and policy analysts seeking a national overview of the code’s clinical meaning and payer landscape. Data not available in the input is noted where applicable in the detailed sections.
Billing Code Overview
HCPCS Level II code J2940 represents an injection of somatrem, 1 mg. This itemized supply code is used to report administration or provision of somatrem—an engineered growth hormone preparation—measured per 1 mg unit.
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Service type: Injectable biologic/therapeutic agent
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Typical site of service: Outpatient infusion or injection setting, physician office, or clinic
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or young-adult patient with growth hormone deficiency presenting to an ambulatory infusion clinic or pediatric endocrinology office for parenteral hormone replacement. The clinician prescribes J2940 (somatrem, 1 mg) to be administered by subcutaneous injection daily or according to the endocrinologist's regimen. Clinical workflow: initial evaluation and diagnosis with history, growth charts, and laboratory testing; prescription of somatrem with dosing based on weight; patient or caregiver teaching on subcutaneous injection technique and storage; administration in clinic for the first dose or for patients requiring supervised administration; documentation of lot number, expiration, dose, route, site, and patient response; scheduling of follow-up visits for growth monitoring and periodic laboratory monitoring (IGF-1, glucose). Typical site of service is outpatient clinic, physician office, or ambulatory infusion/ injection center. Typical patient scenario: a 9-year-old with short stature, decreased growth velocity, confirmed growth hormone deficiency, receiving weekly supply of somatrem with initial observed injection and ongoing monthly follow-up visits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when substantially greater work is required for preparation, teaching, or complex administration beyond typical injection services. |