2025 HCPCS code J1611
(Active) Effective Date: N/A Drugs Administered Other than Oral Method - Drugs, Administered by Injection Feed
Injection, glucagon hydrochloride (Fresenius Kabi), not therapeutically equivalent to J1610, per 1 mg.
Modifier JW may be applicable to report discarded portions of a single-dose container.
Medical necessity for glucagon hydrochloride is established by the presence of severe hypoglycemia requiring immediate intervention or its use as a necessary diagnostic aid in a radiological examination.
Providers administer glucagon hydrochloride to treat severe hypoglycemia or as a diagnostic aid. Dosage varies but is typically 0.2 mg to 2 mg. Administration may be subcutaneous, intramuscular, or intravenous. The dosage form is a 1 mg single-dose vial.
In simple words: This code covers a 1 mg injection of a specific brand of glucagon (Fresenius Kabi) used to treat very low blood sugar or for diagnostic imaging of the digestive system. It is not the same as the glucagon covered by code J1610.
This code represents 1 mg of glucagon hydrochloride manufactured by Fresenius Kabi. This drug is not therapeutically equivalent to J1610. It is typically administered by injection to treat severe hypoglycemia (low blood sugar) or used as a diagnostic aid during radiologic examinations.
Example 1: A patient with diabetes presents to the emergency room with severe hypoglycemia. The provider administers 1 mg of glucagon hydrochloride (Fresenius Kabi) intramuscularly., A patient undergoing a radiologic examination of the gastrointestinal tract requires medication to temporarily inhibit movement. The provider administers 0.5 mg of glucagon hydrochloride (Fresenius Kabi) intravenously., A patient with diabetes experiences a severe hypoglycemic episode at home. A family member administers a pre-filled syringe containing 1 mg of glucagon hydrochloride (Fresenius Kabi) subcutaneously.
Documentation should include the diagnosis (e.g., severe hypoglycemia, diagnostic aid), dosage administered, route of administration, patient's response to treatment, and medical necessity.
** This code specifically represents glucagon hydrochloride manufactured by Fresenius Kabi, and is not therapeutically equivalent to drugs represented by other glucagon hydrochloride codes. Always check individual payer guidelines for specific billing requirements.
- Specialties:Emergency Medicine, Endocrinology, Radiology
- Place of Service: "Office", "Home", "Inpatient Hospital", "Emergency Room - Hospital", "Ambulatory Surgical Center", "Outpatient Hospital", "Telehealth Provided in Patient’s Home", "Independent Clinic", "Federally Qualified Health Center"