2025 HCPCS code J1610
(Active) Effective Date: N/A Revision Date: N/A Drugs - Drugs Administered Other than Oral Method Drugs, Administered by Injection Feed
Injection, glucagon hydrochloride, per 1 mg.
Modifiers may be applicable depending on the circumstances of administration and the payer requirements. Consult payer-specific guidelines and the most recent HCPCS modifier information.
Medical necessity for glucagon is established in cases of hypoglycemia, particularly when oral glucose intake is ineffective or impossible, or during specific diagnostic procedures where slowing gastric motility is required for better visualization. Documentation supporting the clinical indication is required for reimbursement.
Physicians and other qualified healthcare providers are responsible for administering glucagon, though this code only represents the drug itself, not its administration.The ordering and oversight of the drug remain a physician's responsibility.
In simple words: This code is for glucagon, a medicine given as a shot to raise blood sugar levels.One unit of this code equals 1 milligram of glucagon. The shot can be given into a muscle, vein, or under the skin.This code only covers the cost of the medicine itself, not the cost of the shot.
This HCPCS code represents the drug glucagon hydrochloride, administered via injection, priced per 1 mg.Glucagon is a hormone that increases blood glucose levels.It can be administered intramuscularly, intravenously, or subcutaneously. This code only covers the drug itself; separate codes are used for administration.The drug is used to treat hypoglycemia, aid in digestion, and assist in certain diagnostic procedures.
Example 1: A patient with severe hypoglycemia (low blood sugar) in a hospital setting receives an intravenous injection of glucagon to rapidly raise their blood glucose levels., A patient experiencing a mild hypoglycemic episode at home is given a subcutaneous injection of glucagon by a family member or caregiver following physician's instructions., During an upper gastrointestinal radiologic exam, glucagon is administered intramuscularly to slow gastric motility for improved visualization during imaging procedures.
* Diagnosis of hypoglycemia or clinical indication for glucagon administration.* Documentation of the route of administration (IM, IV, or SC).* Documentation of the amount of glucagon administered.* Physician's order for the drug.
** This code represents only the drug itself; separate procedure codes are necessary for billing the administration of glucagon.
- Payment Status: Active
- Modifier TC rule: The TC modifier (technical component) does not typically apply to this code, as it represents the drug itself, not the administration.However, this could be subject to payer specific rules, consult your guidelines.
- Fee Schedule: Fee schedules for this code vary by payer.Historical data will not be included here, but this information can be found by referring to prior fee schedules with your relevant payers.
- Specialties:Endocrinology, Emergency Medicine, Gastroenterology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital, Ambulatory Surgical Center