2025 HCPCS code J0137
(Active) Effective Date: N/A Revision Date: N/A Drugs - Drugs Administered Other than Oral Method Drugs, Administered by Injection Feed
This HCPCS code represents 10 mg of injectable acetaminophen (Hikma brand), not therapeutically equivalent to other acetaminophen injection codes.
Modifiers may apply depending on the circumstances of administration.Check payer guidelines and NCCI edits for allowed modifiers.
The medical necessity for J0137 is determined by the patient's clinical condition, which requires pain or fever reduction that cannot be effectively achieved through oral medication or other means.Documentation should clearly link the need for intravenous acetaminophen to the patient's clinical picture.
Physicians or other qualified healthcare providers authorized to administer intravenous medications are responsible for determining the appropriate dosage and administering J0137.The clinical responsibility includes assessing the patient's condition, selecting the appropriate dosage, monitoring for adverse reactions, and documenting the administration properly.Proper documentation is crucial for accurate billing and reimbursement.
In simple words: This code is for a 10mg dose of a pain and fever reducer injection made by Hikma.It's different from other similar injections.The doctor gives this shot to help with pain or fever. You will need a separate code if the doctor gives the shot.
HCPCS code J0137 represents 10 mg of acetaminophen manufactured by Hikma Pharmaceuticals.This code is specifically for injectable acetaminophen from Hikma and is not considered therapeutically equivalent to other acetaminophen injection codes (like J0131). The drug is typically administered intravenously (IV) to manage pain or fever.Each 10 mg dose requires a separate reporting of this code.If a portion of a single-dose unit is discarded, modifier JW may be applicable, but payer guidelines should be consulted. This code represents the supply of the drug; separate coding might be necessary for administration, according to payer guidelines.
Example 1: A patient presents to the emergency department with severe post-surgical pain. The physician orders 40 mg of intravenous acetaminophen (Hikma) for pain management. Four units of J0137 would be reported., A patient in an inpatient hospital setting experiences a high fever. The physician orders an IV infusion of acetaminophen (Hikma) to reduce the fever. The amount used determines the number of units billed using J0137., A patient undergoing chemotherapy develops severe pain. After assessing the patient, the oncologist orders 20mg of intravenous acetaminophen (Hikma) for pain relief. Two units of J0137 will be reported, along with appropriate documentation.
* Patient's diagnosis justifying the need for intravenous acetaminophen.* Physician's order specifying the dosage and administration method.* Documentation of administration (time, route, and amount administered).* Any adverse reactions observed and how they were managed.* Supporting clinical documentation (e.g., progress notes, pain assessment scales).
** J0137 is specific to acetaminophen manufactured by Hikma Pharmaceuticals and is not interchangeable with other acetaminophen injection codes due to the lack of therapeutic equivalence.Always check payer-specific guidelines for billing and reimbursement.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to J0137 as it represents the drug supply.However, a professional component (26) modifier might be used if the administration is billed separately.Payer specific guidelines need to be checked.
- Specialties:Emergency Medicine, Anesthesiology, Oncology, Hospitalist Medicine, Critical Care
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital, Ambulatory Surgical Center