{"id":162196,"date":"2026-07-23T09:42:11","date_gmt":"2026-07-23T09:42:11","guid":{"rendered":"https:\/\/pabau.com\/?p=162196"},"modified":"2026-08-17T12:10:40","modified_gmt":"2026-08-17T12:10:40","slug":"hcpcs-code-s0166","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/","title":{"rendered":"HCPCS Code S0166: Injection, olanzapine, 2.5 mg"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"HCPCS Code S0166: Injection, olanzapine, 2.5 mg\",\"description\":\"HCPCS Code S0166 covers injection, olanzapine, 2.5 mg. Learn its deleted status, payer coverage rules, NDC crosswalk, and replacement billing options.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-s0166\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-23\",\"dateModified\":\"2026-07-23\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>HCPCS Code S0166 described Injection, olanzapine, 2.5 mg &#8211; a Temporary National S-code used mainly by Medicaid managed care and select private payers, not Medicare.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>S0166 was deleted effective October 1, 2023, per the Q4 2023 HCPCS quarterly update, so any claim still using it will be rejected.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CMS established J2359 (Injection, olanzapine, 0.5 mg) as the direct replacement, but the unit of measure changed, so billed quantities need converting from the old 2.5 mg basis.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau centralizes claims through a claims dashboard, submits to insurers or by email, validates details before submission, and reconciles payments against insurer-specific price lists.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\"><strong>HCPCS Code S0166<\/strong> describes Injection, olanzapine, 2.5 mg &#8211; a Temporary National S-code that Medicaid managed care organizations and select private payers used to bill the short-acting antipsychotic injection. Medicare generally doesn&#8217;t recognize S-codes, including this one.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">S0166 was deleted effective October 1, 2023, per the Q4 2023 HCPCS quarterly update. CMS established J2359 (Injection, olanzapine, 0.5 mg) as the direct replacement. The unit of measure changed from 2.5 mg to 0.5 mg per unit, so billed quantities need converting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For coders and billing teams working with psychiatric practices or behavioral health facilities, understanding the status and proper handling of HCPCS Code S0166 prevents costly claim rejections. This reference covers the code description, payer coverage rules, NDC crosswalk, reimbursement context, documentation requirements, and current crosswalk guidance.<\/p>\n\n\n\n<h2 id=\"h-hcpcs-code-s0166-definition-and-clinical-description\" class=\"wp-block-heading\">HCPCS Code S0166: Definition and clinical description<\/h2>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Attribute<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Details<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">HCPCS Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">S0166<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official Description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, olanzapine, 2.5 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code Series<\/td>\n<td style=\"padding:12px 16px;color:#374151\">HCPCS Level II, S-code (Temporary National Code)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Drug Class<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Atypical antipsychotic<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">FDA-Approved Indications<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Acute agitation associated with schizophrenia and bipolar I disorder (manic or mixed episodes) &#8211; per FDA labeling for the IM formulation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code Status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Deleted \/ Inactive<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Primary Payer<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicaid managed care, select private payers<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare Coverage<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Generally not recognized<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Olanzapine is an atypical antipsychotic. The FDA has approved the short-acting intramuscular formulation &#8211; the one S0166 and its replacement, J2359, bill for &#8211; specifically for acute agitation associated with schizophrenia and bipolar I disorder. It&#8217;s administered in clinical settings when oral dosing isn&#8217;t appropriate or a rapid onset of action is needed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">S0166 covered the 2.5 mg per-unit dose under the HCPCS Level II S-code series. Its replacement, J2359, covers 0.5 mg per unit &#8211; a smaller unit size that changes how billed quantities are calculated.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices billing for injectable antipsychotics in psychiatric settings should note that S-codes like S0166 were designed as Temporary National Codes. They cover drugs and services the permanent HCPCS Level II code set doesn&#8217;t address, and they&#8217;re subject to deletion when the code is no longer needed or a permanent code supersedes it.<\/p>\n\n\n\n<h2 id=\"h-code-status-is-s0166-still-active\" class=\"wp-block-heading\">Code status: Is S0166 still active?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">HCPCS Code S0166 is deleted, effective October 1, 2023 (last valid date September 30, 2023), per the Q4 2023 HCPCS quarterly update. All major HCPCS reference sources, including AAPC, HCPCSData.com, and FindACode, consistently mark this code as no longer active. Submitting a deleted code to any payer will result in an automatic claim rejection.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code Status Detail<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Current Status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Deleted \/ Inactive<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Termination Note<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Deleted effective October 1, 2023 (last valid date September 30, 2023), per the Q4 2023 HCPCS quarterly update<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billing Impact<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Claim will reject; use active replacement or NDC-based billing<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Source Confirmation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">AAPC, HCPCSData.com, FindACode all mark as deleted<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">When a HCPCS code is deleted, payers update their claim processing systems to reject it. Coders who are unaware of the deletion &#8211; particularly those working from older superbills or fee schedules &#8211; may continue submitting S0166 without realizing claims will fail. A quarterly review of HCPCS updates through the <a href=\"https:\/\/www.aapc.com\/codes\/hcpcs-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC HCPCS code directory<\/a> helps catch these changes early.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Audit your superbill or charge capture system at the start of each calendar year and again after each CMS quarterly update. Deleted HCPCS codes like S0166 should be flagged as inactive and removed from payer-specific fee schedules immediately to prevent automatic claim rejections.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-understanding-hcpcs-s-codes-and-medicaid-billing\" class=\"wp-block-heading\">Understanding HCPCS S-codes and Medicaid billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">S-codes are commonly confused with permanent HCPCS Level II codes. Knowing how they function determines which payers will process a claim submitted under one.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">S-codes are <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/healthcare-common-procedure-system\" target=\"_blank\" rel=\"nofollow noopener\">Temporary National Codes<\/a> established and maintained by the Centers for Medicare and Medicaid Services (CMS). Medicaid managed care organizations and select private payers use them to cover drugs and services that permanent HCPCS codes don&#8217;t address.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare generally does not recognize HCPCS S-codes, including S0166. Submitting an S-code to Medicare results in rejection. This applies broadly across the S-code series, though coders should verify against current CMS policy for specific exceptions.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Medicaid managed care:<\/strong> Primary payer type for S-code recognition; individual state Medicaid programs vary in their acceptance<\/li>\n\n\n\n<li><strong>Private payers:<\/strong> Some commercial insurers accept S-codes; payer-specific policy applies<\/li>\n\n\n\n<li><strong>Medicare:<\/strong> Generally does not recognize HCPCS S-codes; claims will typically reject<\/li>\n\n\n\n<li><strong>Blue Cross\/Blue Shield and regional plans:<\/strong> Coverage varies; verify per contract<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Good practice management workflows include maintaining a payer matrix that maps each HCPCS code &#8211; including S-codes &#8211; to the specific payers that accept them. This prevents teams from submitting S0166 or any S-code to a non-accepting payer. Behavioral health-focused codes like H0001 follow the same logic &#8211; confirm Medicaid acceptance before billing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understanding <a href=\"https:\/\/pabau.com\/blog\/what-is-practice-management-software\/\">how practice management software works<\/a> makes it clearer where temporary codes fit in your billing system.<\/p>\n\n\n\n<h2 id=\"h-payer-coverage-for-hcpcs-code-s0166\" class=\"wp-block-heading\">Payer coverage for HCPCS Code S0166<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Because S0166 is a deleted code, payer coverage is a historical question for most billing teams. Understanding the original coverage landscape still matters when conducting claim audits, correcting historical billing errors, or reviewing past accounts receivable.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payer Type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">S0166 Coverage<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Not recognized<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicare generally excludes S-codes; verify current CMS policy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicaid managed care<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Potentially covered (when active)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies by state Medicaid program; code is now deleted<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Private \/ commercial payers<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies by payer contract<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Some commercial plans accepted S-codes; verify per plan<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">All payers (current)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Will reject<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Code is deleted; no payer should process it today<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">For practices working with HIPAA-compliant documentation practices and Medicaid billing, payer-specific coverage policies for injectable antipsychotics continue to evolve. Even when S0166 was active, Medicaid programs in different states applied different rules, making uniform billing guidance difficult.<\/p>\n\n\n\n<h2 id=\"h-reimbursement-and-pricing-for-olanzapine-2-5-mg-injection\" class=\"wp-block-heading\">Reimbursement and pricing for olanzapine 2.5 mg injection<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When S0166 was active, reimbursement for physician-administered drugs like olanzapine injection typically followed an Average Sales Price (ASP) methodology under Medicare Part B. For Medicaid-covered scenarios under S-codes, reimbursement methodology varied by state &#8211; some states used ASP, others used actual acquisition cost or a state-defined fee schedule.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because S0166 is deleted, its ASP-based reimbursement rates are no longer published. For current rates, reference J2359 and check the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS fee schedule<\/a> lookup. Its billing unit is 0.5 mg, not 2.5 mg, so factor in the smaller unit size when comparing rates.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For buy-and-bill scenarios, the practice purchases the drug and then seeks reimbursement from the payer. With a deleted code like HCPCS Code S0166.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-s0166\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Automate claims and billing with Pabau<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Track drug-specific reimbursement rates quarterly. ASP values update every three months via CMS publications. For olanzapine injection, bill J2359 (0.5 mg per unit) going forward, and audit any open S0166 claims for unit-conversion errors before resubmitting.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-ndc-to-hcpcs-crosswalk-for-s0166\" class=\"wp-block-heading\">NDC to HCPCS crosswalk for S0166<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">National Drug Codes (NDCs) are 10-digit or 11-digit codes assigned by the FDA to identify specific drug products by manufacturer, product, and package size. When billing physician-administered drugs, many payers require both the HCPCS code and the corresponding NDC to validate the claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For olanzapine injection, NDC codes vary by manufacturer and formulation. Because the FDA assigns NDCs to individual drug products, multiple NDCs may correspond to the same HCPCS code when different manufacturers produce the same drug. The National Library of Medicine&#8217;s <a href=\"https:\/\/clinicaltables.nlm.nih.gov\/apidoc\/hcpcs\/v3\/doc.html\" target=\"_blank\" rel=\"nofollow noopener\">HCPCS API<\/a> provides a searchable interface for cross-referencing HCPCS codes with associated drug data.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>NDC format:<\/strong> 11 digits (labeler code + product code + package code), often formatted as XXXXX-XXXX-XX<\/li>\n\n\n\n<li><strong>Payer requirement:<\/strong> Many Medicaid programs require NDC submission alongside the HCPCS code<\/li>\n\n\n\n<li><strong>NDC unit of measure:<\/strong> Must match the billing unit &#8211; 0.5 mg per unit under J2359, not the old 2.5 mg basis used for S0166<\/li>\n\n\n\n<li><strong>Multiple NDCs per code:<\/strong> Different olanzapine manufacturers will have different NDCs mapping to the same drug descriptor<\/li>\n\n\n\n<li><strong>Verification source:<\/strong> FDA NDC Directory or drug labeling for confirmed current NDC values<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Because specific NDC values for olanzapine injection vary by manufacturer and are subject to change, coders should verify current NDCs directly from the FDA NDC Directory or from the drug&#8217;s package insert. Stating specific NDCs without confirmed sourcing risks submitting incorrect billing data.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Teams managing standardized medical forms for drug administration should capture NDC information at the point of administration to support accurate claim submission.<\/p>\n\n\n\n<h2 id=\"h-crosswalk-and-replacement-codes-after-s0166-deletion\" class=\"wp-block-heading\">Crosswalk and replacement codes after S0166 deletion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When a HCPCS code is deleted, coders need to identify the correct active billing pathway. For HCPCS Code S0166, CMS provided a direct answer: J2359 (Injection, olanzapine, 0.5 mg) is the replacement code, added with the January 2024 OPPS update and assigned to APC 0724.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The unit of measure changed along with the code. S0166 billed in 2.5 mg units; J2359 bills in 0.5 mg units. A claim written on the old 2.5 mg basis needs its billed quantity converted &#8211; five times the number of units &#8211; or it will underbill or overbill the payer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">J2359 is the primary pathway for most payers, but a few scenarios still call for payer-specific verification. J2359 follows the same J-code format used for most physician-administered drugs today.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Payer-specific fee schedule check:<\/strong> Confirm the payer has loaded J2359 and its rate before submitting, since adoption timelines vary slightly by plan<\/li>\n\n\n\n<li><strong>NDC-based billing:<\/strong> Some Medicaid programs permit or require NDC-only billing for certain drugs alongside or instead of J2359<\/li>\n\n\n\n<li><strong>Unlisted drug code fallback:<\/strong> J3490 (Unclassified drugs) or J3590 (Unclassified biologicals) for injectable products that lack a specific HCPCS code &#8211; not 99070, which covers supplies and is commonly denied for injections<\/li>\n\n\n\n<li><strong>Commercial payer carve-outs:<\/strong> Some private plans may continue accepting the S-code series under their own fee schedules despite the deletion<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">For most billing scenarios, submit J2359 (0.5 mg per unit) and verify the payer has it loaded correctly. For edge cases, contact the payer directly, provide the drug name, formulation, and dose, and confirm which code or NDC billing method they accept. Reference PGM Billing&#8217;s <a href=\"https:\/\/www.pgmbilling.com\/hcpcs-lookup-tool\/\" target=\"_blank\" rel=\"nofollow noopener\">HCPCS lookup tool<\/a> for a free search of current active HCPCS codes.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Streamline your HCPCS billing and claims management                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims dashboard helps behavioral health and psychiatric practices submit claims to insurers, validate details before submission, and reconcile payments &#8211; all in one platform.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard for HCPCS billing\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-documentation-requirements-for-olanzapine-injection-billing\" class=\"wp-block-heading\">Documentation requirements for olanzapine injection billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Regardless of which active code replaces S0166 in the billing workflow, documentation requirements for olanzapine injection claims remain consistent across payers. Missing or inadequate documentation is the second most common reason for denials after using incorrect codes.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Diagnosis:<\/strong> ICD-10-CM code supporting medical necessity (schizophrenia, bipolar disorder, or other FDA-approved indication)<\/li>\n\n\n\n<li><strong>Route of administration:<\/strong> Injectable route must be documented in the clinical note<\/li>\n\n\n\n<li><strong>Dose administered:<\/strong> Must match the billed HCPCS unit &#8211; 0.5 mg per unit under J2359 (previously 2.5 mg per unit under the deleted S0166)<\/li>\n\n\n\n<li><strong>Prescribing provider:<\/strong> Order or prescription from an authorized prescriber, maintained in the patient record<\/li>\n\n\n\n<li><strong>Date and time of administration:<\/strong> Documented in the clinical note or medication administration record<\/li>\n\n\n\n<li><strong>NDC submitted:<\/strong> If payer requires NDC, document the specific product lot and NDC on the claim<\/li>\n\n\n\n<li><strong>Medical necessity letter:<\/strong> Some Medicaid programs require prior authorization with a supporting letter for injectable antipsychotics<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Teams working with prescription management tools should capture dose, route, and administration details at the point of care so they&#8217;re ready for claim submission.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For bipolar patients specifically. <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-s0166\/end-the-paper-chase-and-delight-patients-with-modern-convenience.webp\" alt=\"End the paper chase and delight patients with modern convenience\"\/><figcaption class=\"wp-element-caption\"><em>End the paper chase and delight patients with modern convenience<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Related HCPCS codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-q9966\/\">HCPCS code Q9966 \u2014 Low Osmolar Contrast Material<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-s0189\/\">HCPCS code S0189 \u2014 Deleted and replaced by J1073 in<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-s0201\/\">HCPCS code S0201 \u2014 Partial Hospitalization Services Per Diem<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-s0265\/\">HCPCS code S0265 \u2014 Genetic counseling<\/a><\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-how-pabau-supports-hcpcs-code-management-and-drug-billing\" class=\"wp-block-heading\">How Pabau supports HCPCS code management and drug billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Managing documentation and billing across multiple payers takes coordination, especially when a code like S0166 gets deleted mid-cycle. Practice management software like Pabau brings claims into the same system as clinical documentation, which helps psychiatric and behavioral health practices keep billing organized.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Specifically, Pabau&#8217;s claims dashboard supports the following workflows relevant to HCPCS billing:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A claims dashboard that shows the status of every submitted claim in one place<\/li>\n\n\n\n<li>Direct submission to insurers, or by email, from the same system used for scheduling and clinical notes<\/li>\n\n\n\n<li>Pre-submission validation that checks details like membership numbers and authorization codes before a claim goes out<\/li>\n\n\n\n<li>Payment reconciliation, so payments can be matched against what was billed<\/li>\n\n\n\n<li>Insurer-specific price lists that keep billed amounts aligned with each payer&#8217;s agreed rates<\/li>\n\n\n\n<li>Supporting EHR integration for practices that need to connect billing with clinical notes across systems<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">HCPCS Code S0166 for Injection, olanzapine, 2.5 mg is deleted. Submitting it today results in an automatic claim rejection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For most payers, that means billing J2359 (0.5 mg per unit) instead &#8211; just remember to convert the unit quantity from the old 2.5 mg basis. For edge cases, verify directly with the payer whether they want NDC-based billing or an unlisted drug code instead.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To see how Pabau&#8217;s claims dashboard and insurer-specific price lists work for psychiatric and behavioral health billing, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a> with the team.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Curious how vaccine and biologic injections get coded?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-90677\/\">90677<\/a> breaks down billing, reimbursement, and modifiers for a comparable injectable claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need a broader documentation refresher?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/nursing-documentation\/\">nursing documentation guide<\/a> covers the legal and clinical-note requirements that support claims like the one for olanzapine injection.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding for another specialty too?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/chiropractic-billing-cheat-sheet\/\">chiropractic billing cheat sheet<\/a> applies the same crosswalk logic you would use for any deleted or replaced code.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1784794445805\"><h3 class=\"schema-faq-question\">What is HCPCS Code S0166?<\/h3> <p class=\"schema-faq-answer\">HCPCS Code S0166 is a Level II HCPCS code that describes Injection, olanzapine, 2.5 mg. It belongs to the S-code series of Temporary National Codes maintained by CMS, used primarily by Medicaid managed care organizations and select private payers. The code is currently listed as deleted and inactive.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784794445806\"><h3 class=\"schema-faq-question\">Is HCPCS Code S0166 still active or has it been deleted?<\/h3> <p class=\"schema-faq-answer\">S0166 is deleted and inactive. All major HCPCS references, including AAPC and HCPCSData.com, confirm this status. Submitting S0166 on any current claim will result in an automatic rejection. Coders should verify the active replacement code or billing pathway with their specific payer before submitting olanzapine injection claims.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784794445807\"><h3 class=\"schema-faq-question\">Does Medicare cover HCPCS Code S0166?<\/h3> <p class=\"schema-faq-answer\">No. Medicare generally does not recognize HCPCS S-codes, including S0166. The S-code series is designed for Medicaid managed care and select private payers, not Medicare. Providers billing Medicare for olanzapine injection should identify the appropriate active HCPCS or claim approach per current CMS policy.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784794445808\"><h3 class=\"schema-faq-question\">What payers accept HCPCS S-codes like S0166?<\/h3> <p class=\"schema-faq-answer\">Medicaid managed care organizations are the primary payers that recognize HCPCS S-codes. Some commercial and private insurers also accept S-codes depending on their contracts. Medicare generally does not. Because S0166 is now deleted, acceptance is no longer relevant for current claims; verify the active replacement code with each payer individually.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784794445809\"><h3 class=\"schema-faq-question\">How do I bill for olanzapine 2.5 mg injection after S0166 was deleted?<\/h3> <p class=\"schema-faq-answer\">Bill J2359 (Injection, olanzapine, 0.5 mg) &#8211; the direct replacement CMS established for S0166, effective with the January 2024 OPPS update. The unit of measure changed from 2.5 mg to 0.5 mg per unit, so convert the billed quantity accordingly. For edge cases, some payers may still want NDC-based billing or an unlisted drug code (J3490 or J3590) instead, so verify with the payer directly if J2359 is rejected.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784794445810\"><h3 class=\"schema-faq-question\">What NDC code corresponds to HCPCS S0166?<\/h3> <p class=\"schema-faq-answer\">NDC codes for olanzapine 2.5 mg injection vary by manufacturer. Multiple manufacturers may produce the same formulation, each with a distinct NDC. Coders should obtain the specific NDC from the drug&#8217;s package insert or the FDA NDC Directory and submit it alongside the active billing code per payer requirements.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>HCPCS Code S0166 describes Injection, olanzapine, 2.5 mg &#8211; a Temporary National S-code that Medicaid managed care organizations and select private payers used to bill the short-acting antipsychotic injection. Medicare generally doesn&#8217;t recognize S-codes, including this one. S0166 was deleted effective October 1, 2023, per the Q4 2023 HCPCS quarterly update. CMS established J2359 (Injection, [&hellip;]<\/p>\n","protected":false},"author":77,"featured_media":162195,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"88","_yoast_wpseo_content_score":"60","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1548],"tags":[3826,2568,1843,3046,1582,1611,1641,3814,2956,2530,3078],"class_list":["post-162196","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-hcpcs","tag-antipsychotic-medication","tag-behavioral-health-billing","tag-bipolar-disorder","tag-drug-billing","tag-hcpcs","tag-hcpcs-codes","tag-hcpcs-level-ii","tag-medicaid-billing","tag-ndc-reporting","tag-reimbursement","tag-schizophrenia"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>HCPCS Code S0166: Deleted - Bill J2359 Instead<\/title>\n<meta name=\"description\" content=\"HCPCS S0166 (olanzapine 2.5 mg) was deleted Oct 1, 2023. 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The code is currently listed as deleted and inactive.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445806","position":2,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445806","name":"Is HCPCS Code S0166 still active or has it been deleted?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"S0166 is deleted and inactive. All major HCPCS references, including AAPC and HCPCSData.com, confirm this status. Submitting S0166 on any current claim will result in an automatic rejection. Coders should verify the active replacement code or billing pathway with their specific payer before submitting olanzapine injection claims.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445807","position":3,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445807","name":"Does Medicare cover HCPCS Code S0166?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. Medicare generally does not recognize HCPCS S-codes, including S0166. The S-code series is designed for Medicaid managed care and select private payers, not Medicare. Providers billing Medicare for olanzapine injection should identify the appropriate active HCPCS or claim approach per current CMS policy.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445808","position":4,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445808","name":"What payers accept HCPCS S-codes like S0166?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Medicaid managed care organizations are the primary payers that recognize HCPCS S-codes. Some commercial and private insurers also accept S-codes depending on their contracts. Medicare generally does not. Because S0166 is now deleted, acceptance is no longer relevant for current claims; verify the active replacement code with each payer individually.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445809","position":5,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445809","name":"How do I bill for olanzapine 2.5 mg injection after S0166 was deleted?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Bill J2359 (Injection, olanzapine, 0.5 mg) - the direct replacement CMS established for S0166, effective with the January 2024 OPPS update. The unit of measure changed from 2.5 mg to 0.5 mg per unit, so convert the billed quantity accordingly. For edge cases, some payers may still want NDC-based billing or an unlisted drug code (J3490 or J3590) instead, so verify with the payer directly if J2359 is rejected.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445810","position":6,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-s0166\/#faq-question-1784794445810","name":"What NDC code corresponds to HCPCS S0166?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"NDC codes for olanzapine 2.5 mg injection vary by manufacturer. Multiple manufacturers may produce the same formulation, each with a distinct NDC. Coders should obtain the specific NDC from the drug's package insert or the FDA NDC Directory and submit it alongside the active billing code per payer requirements.","inLanguage":"de"},"inLanguage":"de"}]}},"yoast":{"focus_keyword":"HCPCS Code S0166","seo_title":"HCPCS Code S0166: Deleted - Bill J2359 Instead","meta_description":"HCPCS S0166 (olanzapine 2.5 mg) was deleted Oct 1, 2023. Bill J2359 instead - the unit changed from 2.5 mg to 0.5 mg.","content_score":"60","is_cornerstone":"","related_keyphrases":[{"keyword":"deleted HCPCS code","score":61},{"keyword":"S-code Medicaid billing","score":72},{"keyword":"olanzapine injection billing","score":72},{"keyword":"NDC crosswalk HCPCS","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/162196","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/users\/77"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/comments?post=162196"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/162196\/revisions"}],"predecessor-version":[{"id":182846,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/162196\/revisions\/182846"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media\/162195"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media?parent=162196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/categories?post=162196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/tags?post=162196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}