HCPCS code J0380 – Metaraminol bitartrate injection

Key takeaways

HCPCS code J0380 reports injection, metaraminol bitartrate, per 10 mg. Metaraminol is a vasopressor used to treat acute hypotension.

CMS deleted J0380 effective December 31, 2025, with no crosswalk code. It is valid only for dates of service up to that day.

One unit covers 10 mg, so the 0.5 to 10 mg doses on the label bill as 1 unit. A dose that is not a multiple of 10 mg rounds up.

J0380 is not an atropine code. Atropine sulfate, 0.01 mg, bills under J0461, J0462 or J0463.

Practice management software like Pabau keeps the dose and NDC in the clinical record, so the units on the claim match the note.

HCPCS code J0380: Official descriptor and drug overview

HCPCS code J0380 is the Level II code for injection, metaraminol bitartrate, per 10 mg. Metaraminol is a sympathomimetic vasopressor that acts mainly on alpha-adrenergic receptors. It raises both systolic and diastolic blood pressure, and is given by intramuscular, subcutaneous or intravenous injection.

CMS deleted the code effective December 31, 2025, so the reference data below applies to dates of service up to that day.

Descriptor and status data come from the CMS HCPCS Level II file. The CMS HCPCS page publishes each quarterly update.

J0380 deleted: What changed on January 1, 2026

CMS discontinued J0380 in the 2026 annual HCPCS update and named no replacement code. The date of service decides which rule applies, and the drug decides whether J0380 was ever the right code.

• Services on or before December 31, 2025: Bill J0380 as usual. Corrected claims and appeals for those dates also keep J0380.
• Services on or after January 1, 2026: J0380 rejects as invalid. Payers usually expect an unclassified drug code such as J3490, with the drug name, NDC, dose and route in the claim narrative.
• Filing deadline: Medicare allows 12 months from the date of service. A claim for a December 31, 2025 date of service must reach Medicare by December 31, 2026, so earlier dates have already passed their deadline.

The deletion tracks a thin US market. The brand product Aramine and several generics are listed as discontinued in the FDA Orange Book. One generic application, ANDA 211304 from Azurity, was approved in 2021. A November 2026 search of the FDA NDC Directory and DailyMed found no finished metaraminol injection listed.

Metaraminol is still licensed in the UK, where 10 mg/mL ampoules and 0.5 mg/mL prefilled syringes are in use. That is why it appears in many anesthesia references even though US claims for it are rare.

What J0380 covers and what it excludes

J0380 covers the metaraminol bitartrate drug supply for an injection or infusion given in a clinical setting. The US label lists these uses:

• Spinal anesthesia: Prevention and treatment of the acute hypotensive state that occurs with spinal anesthesia.
• Adjunctive treatment of hypotension: Low blood pressure due to hemorrhage, reactions to medications or surgical complications.
• Shock with brain injury: Shock associated with brain damage due to trauma or tumor.

Several items fall outside the code:

• The administration itself: J0380 reports only the drug. The injection or infusion takes its own CPT code.
• Other vasopressors: Phenylephrine, vasopressin and other pressors have their own J-codes.
• Atropine: Atropine is an anticholinergic, not a vasopressor. It bills under J0461, J0462 or J0463.
• Services from 2026 onward: The code no longer exists for those dates of service.

How to calculate J0380 units from the administered dose

Divide the dose given in milligrams by 10, then round any remainder up to the next whole unit. Medicare’s Part B drug guidance bills a dose below the descriptor amount as 1 unit.

Doses come from the US Aramine label. A direct IV dose followed by an infusion is added together before you convert to units. Bill the dose the medication administration record shows, never the full contents of the vial.

NDC, modifiers and administration codes for J0380

NDC reporting

Medicaid programs and many commercial payers require the 11-digit NDC on every drug line. On a CMS-1500, enter the N4 qualifier, the NDC in 5-4-2 format, a unit qualifier such as ML, and the quantity. Take the NDC from the vial you used, since products differ by labeler. A clean claim carries an NDC that matches the administration record.

JW and JZ modifiers

Medicare requires JW for the discarded amount from a single-dose container, and JZ when none was discarded. Both apply only to single-dose containers. The former Aramine product came in 10 mL vials with methylparaben and propylparaben added as preservatives. Check the label of the product you stocked before you add either modifier.

Administration CPT codes

Report the injection separately from the drug. A superbill that lists both lines keeps the pair together.

When an anesthesia provider gives metaraminol during a case, the administration is part of the anesthesia service. In that setting, no separate 96374 is reported for it.

ICD-10 codes that support J0380 medical necessity

Pair J0380 with a diagnosis that documents the hypotension or shock the drug treated. A code for the underlying procedure alone does not explain why a vasopressor was needed.

Obstetric cases take the anesthesia complication codes from the pregnancy chapter instead of T88.59XA. Code to the most specific cause the record supports.

Medicare reimbursement and coverage for J0380

Medicare Part B pays most separately payable drugs at 106% of the Average Sales Price (ASP). CMS updates ASP rates every quarter. Check the CMS ASP pricing files for the quarter of the date of service. Where no ASP rate is listed for J0380, the Medicare contractor prices the line.

In the hospital outpatient setting, Medicare packages many low-cost drugs into the payment for the main procedure. A metaraminol line there may carry no separate payment. Medicaid rates vary by state, so check the billing state’s fee schedule.

Coverage rests on medical necessity. The record must show the blood pressure readings, the cause of the hypotension and the response to the drug.

Common J0380 claim denials and how to avoid them

Most J0380 denials trace back to the date of service, the unit count or a missing link between drug and diagnosis. Denial management works best when each reason is fixed at its source. The table lists the claim adjustment reason code payers most often return, and our guide to denial codes covers the rest.

Documentation the medical record must contain

Payers that audit drug claims look for these elements. Consistent medical billing compliance means each one is in the record before the claim goes out.

• Physician order with drug name (metaraminol bitartrate), dose, route and rate for an infusion
• Dose given and time of administration, from the nursing or anesthesia record
• Blood pressure readings before and after the dose
• The cause of the hypotension or shock
• NDC and lot number from the vial label
• Discarded amount, where a single-dose container was used

Codes frequently confused with J0380

J0380 is easily confused with the atropine code J0461 and its two siblings, and with codes for other vasopressors. Check the code against this table before you file.

How Pabau keeps drug claim lines tied to the record

In many practices, the nurse records a dose in milligrams and the biller converts it to units later. The NDC sits on a vial that was discarded hours earlier. A retired code or a wrong unit count enters the claim at that hand-off.

Pabau keeps the clinical record and billing in one system. The dose, route and NDC are captured once in the administration note. Pabau’s claims management software then builds the claim from that same record.

The result is a drug line that matches the chart. When a payer asks how a unit count was reached, the answer is in the same record as the claim. Every Pabau subscription includes the full feature set, so notes and claims sit together on any plan.

Keep drug doses and claim lines in one record

Pabau captures the dose, route and NDC in the clinical note and builds the claim from the same record. Book a demo to see how it handles drug administration billing.

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Conclusion

J0380 now matters mainly for older claims. It reports metaraminol bitartrate per 10 mg, and only for dates of service through December 31, 2025. The common errors are coding atropine to it, billing it after the deletion, and entering milligrams as units. Each one is caught by checking the date of service, the drug and the dose before the claim leaves.

Pabau keeps that dose and drug detail in the record the claim is built from. To see how it works for drug administration billing, book a demo with the Pabau team.

Continue your research

Need to understand how drug claims move through the billing cycle? Medical billing workflows explained covers how physician-administered drugs are captured, coded, and submitted.

Seeing recurring J-code denials across multiple drugs? Healthcare denial management strategies outlines how to build a denial root-cause analysis workflow.

Want to understand what a clean J-code claim looks like? Clean claim submission requirements covers the fields payers validate before accepting a drug claim.

Billing a different vasopressor? HCPCS code J2371 for phenylephrine walks through its 20 microgram units and the claim lines that go with them.

Reporting the IV push that delivered the drug? CPT code 96374 for IV push covers the administration code, its modifiers and its documentation.

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