HCPCS J0131: Injection Acetaminophen, 10 mg
HCPCS Level II code J0131 denotes injectable acetaminophen measured in 10 mg units and is used to bill for parenteral administration of this analgesic/antipyretic agent. Nationwide, injectable acetaminophen is relevant for inpatient and procedural pain management protocols, perioperative care, and settings where oral administration is not feasible. The code matters because it standardizes reporting for an increasingly utilized non-opioid analgesic option that can affect medication utilization patterns, inpatient pharmacy spend, and perioperative pain pathways.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks and coverage considerations for common payers, an overview of clinical contexts where injectable acetaminophen is billed, and notes on service lines and typical sites of service. The publication aims to clarify billing classification, operational contexts for use, and payer presence to help revenue integrity, coding teams, and policy analysts understand where J0131 fits within hospital and ambulatory procedural billing workflows.
Data not available in the input for specific payor policies, utilization rates, associated ICD-10 diagnoses, related codes, and detailed modifiers.
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Billing Code Overview
HCPCS Level II code J0131 represents the injection formulation of acetaminophen, described as “Injection, acetaminophen, not otherwise specified, 10 mg.” The service type is an injectable analgesic/antipyretic medication administration. The typical site of service for this code is acute care settings such as hospitals, ambulatory surgical centers, or other infusion-capable facilities where parenteral medications are administered.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center or emergency department with acute severe pain or when oral acetaminophen is contraindicated or ineffective (for example, post-operative pain, acute musculoskeletal injury, or severe headache where oral intake is not feasible). The clinician (an emergency physician, anesthesiologist, hospitalist, or infusion nurse under physician order) verifies medication allergies, calculates dose based on indication and milligram strength, prepares the intravenous or intramuscular J0131 product, documents informed consent when required, and administers the injection. Vital signs and pain scores are monitored before and after administration. The encounter may include evaluation and management, procedural analgesia, or adjunctive therapies; medication administration is documented in the medication administration record, including lot number, route, dose, and time. Billing uses HCPCS Level II code J0131 for the supplied injected acetaminophen product (10 mg unit), with appropriate modifiers to indicate service circumstances and any related professional services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/waste | Use when part of a single-use vial is discarded and payor requires reporting of discarded controlled or injectable drug waste. |
JZ | No drug amount discarded/not wasted | Use when the entire vial or container was administered with no waste. |
HC | Data not available in the input. | Data not available in the input. |
59 | Distinct procedural service | Use to indicate a separate and distinct service from other services on the same day (e.g., separate injection from other procedures). |
25 | Significant, separately identifiable E/M service by the same physician on the same day | Use when a separate evaluation and management visit is provided in addition to medication administration. |
52 | Reduced services | Use when a service is partially reduced or not completed as originally planned (for example, partial infusion due to intolerance). |
53 | Discontinued procedure | Use when administration is started but discontinued for patient safety reasons. |
78 | Unplanned return to operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Use when re-intervention is required related to the primary procedure that necessitated analgesia. |
59 | Distinct procedural service | Use when the injectable acetaminophen is billed in addition to another procedure that is distinct and separate. |
GQ | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207P00000X | Anesthesiology | Anesthesiologists commonly order or administer parenteral analgesics in perioperative or procedural settings. |
208000000X | Emergency Medicine | Emergency physicians frequently use parenteral acetaminophen for acute pain when oral route is unsuitable. |
363A00000X | Nursing — Registered Nurse | Infusion or procedural nurses prepare and administer injectable medications under clinician order. |
207L00000X | Pain Medicine | Pain specialists may use parenteral acetaminophen as part of multimodal analgesia. |
207R00000X | Surgery | Surgeons may request intraoperative or postoperative parenteral acetaminophen for analgesia. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
G89.3 | Neoplasm related pain (acute) | Parenteral acetaminophen used for acute cancer-related pain when oral route is not feasible. |
G89.11 | Acute pain due to trauma | Injectable acetaminophen given for acute musculoskeletal or traumatic pain. |
G89.18 | Other acute postoperative pain | Used for postoperative analgesia when IV or IM acetaminophen is indicated. |
M54.5 | Low back pain | Parenteral administration for severe acute exacerbations when oral therapy is not tolerated. |
R51 | Headache | IV acetaminophen used for severe headache or migraine when oral administration is not possible. |
J02.9 | Acute pharyngitis, unspecified | Parenteral acetaminophen may be used when severe throat pain prevents swallowing oral medications. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | Billed when the acetaminophen injection is part of an infusion service lasting up to one hour or when IV infusion setup/time-based services are provided. |
96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular | Billed for the actual administration of a single injection when a separate administration code is required in addition to the drug HCPCS code. |
99283 | Emergency department visit for the evaluation and management of a patient, typically 30 minutes | May be billed when an emergency department E/M service is provided in addition to the injectable medication. |
01990 | Intraoperative medication, not otherwise specified (specify) | Billed when anesthesiology or surgical team documents intraoperative administration of parenteral analgesic as part of anesthesia services. |
99199 | Unlisted anesthesia procedure | Used when a specific anesthesia-related billing for an unusual administration circumstance is required alongside the drug supply code. |