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J2278 Ziconotide injection

J Codes (Drugs)

Also known as: ziconotide, Prialt

Injection of ziconotide. A selective N-type calcium channel blocker for severe chronic pain.

In Plain Language

intrathecal pain medication; nerve channel pain blocker

Clinical Context

Used for severe chronic pain intolerant to or failed by other therapies. Administered by intrathecal infusion pump with narrow therapeutic window.

RVU Information

CPT J2278 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.

Billing & Documentation

J-codes represent drugs administered by a healthcare provider (not self-administered). Documentation must include the drug name, dosage, route of administration, and medical necessity. Most payers require the National Drug Code (NDC) on the claim. Bill the appropriate administration code (96365-96379) in addition to the drug code.

Specialties

Pain ManagementAnesthesiologyNeurology

Frequently Asked Questions

What is CPT code J2278?

CPT J2278 (Ziconotide injection) is a J Codes (Drugs) code. Injection of ziconotide. A selective N-type calcium channel blocker for severe chronic pain.

How is J2278 administered?

CPT J2278 is administered by a healthcare provider, typically via injection or infusion. Used for severe chronic pain intolerant to or failed by other therapies. Administered by intrathecal infusion pump with narrow therapeutic window. It is used by Pain Management, Anesthesiology, Neurology.

When is CPT J2278 used?

Used for severe chronic pain intolerant to or failed by other therapies. Administered by intrathecal infusion pump with narrow therapeutic window.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.