Summary & Overview
HCPCS Level II J3310: Perphenazine Injection, Up to 5 mg
HCPCS Level II code J3310 denotes the injectable antipsychotic medication perphenazine, specified as “up to 5 mg.” This code identifies the drug product supplied for intramuscular administration and is relevant to billing for psychiatric and behavioral health treatments that require parenteral antipsychotic therapy. Nationally, medication codes such as J3310 matter because they affect drug reimbursement, inventory management, and billing consistency across outpatient and ambulatory settings.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for injectable perphenazine, typical sites of service where the code is billed, and the payer landscape addressed in the full publication. The report also outlines billing considerations and common modifiers used with injectable drug codes (listed elsewhere in the document), benchmarks for reimbursement where available, and relevant policy updates that can influence coverage and coding practice.
The publication is intended for billing managers, revenue cycle staff, clinicians involved in medication administration, and policy analysts seeking a national-level reference for J3310. It provides actionable detail on code definition, service type, and payer coverage patterns to support accurate claim submission and reimbursement alignment.
Billing Code Overview
HCPCS Level II code J3310 represents an injectable formulation of perphenazine, dosed up to 5 mg per administration. This code covers the medication supply and is used when perphenazine is delivered by injection.
Service Type: Drug administration / Injectable antipsychotic
Typical Site of Service: Outpatient clinic, physician office, or other ambulatory setting where intramuscular injections are administered
Clinical & Coding Specifications
Clinical Context
A 48-year-old male with chronic schizophrenia presents to an outpatient behavioral health clinic for maintenance antipsychotic therapy. The patient has a documented history of poor adherence to oral medications and recurrent psychotic exacerbations. The psychiatrist determines long-acting injectable therapy is not appropriate and prescribes intramuscular perphenazine for short-term symptom control during an acute agitation episode and as bridge therapy while long-term planning occurs. The clinic nurse performs a medication reconciliation, confirms allergies and vitals, obtains informed consent, and administers J3310 (Injection, perphenazine, up to 5 mg) intramuscularly in the deltoid using standard aseptic technique. Post-injection observation is performed for 15–30 minutes to monitor for extrapyramidal symptoms, oversedation, or injection-site reaction. Documentation includes indication, dose, lot number, route, site, patient tolerance, and aftercare instructions. Billing uses the J3310 HCPCS Level II code; appropriate modifiers are appended when medically necessary and supported by documentation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or complexity of administering is substantially greater than typical and documented (rare for simple IM injection). |