2025 HCPCS code J1811
(Active) Effective Date: N/A Revision Date: N/A Drugs - Drugs, Administered by Injection Drugs Administered Other than Oral Method Feed
50 units of Fiasp® insulin for administration via durable medical equipment (insulin pump).
Modifiers may be applicable depending on the circumstances of service, such as the place of service or administration method.Consult appropriate coding guidelines for applicable modifiers.
Medical necessity for J1811 is established through documentation supporting the diagnosis of diabetes mellitus requiring insulin therapy, and the clinical decision to use an insulin pump to deliver Fiasp® insulin based on the patient's specific metabolic needs and clinical presentation.
Dosage of Fiasp® is determined by the clinician based on patient's blood glucose levels and management goals.The clinician is responsible for ordering the medication and monitoring its effects. Administration may be by nurse or other qualified personnel.
- Drugs Administered Other than Oral Method
- J0120-J8999 > Drugs, Administered by Injection > J0120-J7175
In simple words: This code covers 50 units of the diabetes medicine Fiasp®, given through a special pump. The amount needed depends on the person's blood sugar levels and health goals.This is only for Fiasp® given with a medical pump.
This HCPCS code, J1811, represents 50 units of Fiasp® insulin administered through durable medical equipment (DME), specifically an insulin pump.The insulin is supplied in a 10 mL multiple-dose vial with 100 units/mL.Dosage varies depending on patient needs, blood glucose monitoring, and blood glucose management goals.This code is specific to Fiasp® administered via an insulin pump; it's used for patients with diabetes mellitus to control high blood sugar.Report this code for each 50 units of Fiasp® administered through DME.
Example 1: A type 1 diabetic patient requires continuous subcutaneous insulin infusion (CSII) therapy via an insulin pump.J1811 is reported for each 50 units of Fiasp® insulin administered through the pump., A patient with type 2 diabetes is using an insulin pump to manage blood glucose levels.The physician orders Fiasp® insulin via the pump. J1811 is reported based on insulin usage., A patient in an inpatient hospital setting is receiving insulin via an insulin pump as part of their diabetes management plan. The code is reported for each 50-unit dose administered.
* Physician order for Fiasp® insulin.* Documentation of the patient's diabetes diagnosis and insulin requirements.* Records of blood glucose monitoring and adjustments to insulin dosage.* Documentation of insulin pump programming and usage.* Documentation of the amount of Fiasp® administered.
** This code is specific to Fiasp® insulin and should not be used for other insulin types.Always confirm the specific brand of insulin administered before coding.
- Payment Status: Active
- Specialties:Endocrinology, Diabetology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office