Summary & Overview
HCPCS J0136: Injectable Acetaminophen (B. Braun), 10 mg
HCPCS Level II code J0136 denotes a 10 mg injection of acetaminophen (B. Braun) that is not therapeutically equivalent to J0131. This supply-and-administration code captures use of a specific parenteral acetaminophen product and matters nationally because injectable analgesics are integral to perioperative pain control, inpatient pain management, and settings where oral administration is not feasible. Payers across private and public sectors apply distinct coverage and billing rules for injectable medications, influencing access and facility reimbursement.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical context and typical service settings, a review of payer coverage scope and common billing practices, and benchmarks relevant to facility billing lines. The publication also highlights coding distinctions — including non-equivalence to J0131 — that affect product selection and billing. Where specific payer policies or rate data are not available in the input, the report notes that such data are not provided. The content is intended for a national audience of billing professionals, pharmacists, hospital administrators, and policy analysts seeking concise guidance on classification and typical use of HCPCS Level II code J0136.
Billing Code Overview
HCPCS Level II code J0136 describes an injection of acetaminophen (B. Braun) in a 10 mg formulation, noted as not therapeutically equivalent to J0131. The service represented is an injectable analgesic/antipyretic administration intended for direct parenteral use.
Service Type: Injectable medication administration
Typical Site of Service: Hospital inpatient or outpatient settings, ambulatory surgical centers, and other clinical infusion or procedural areas
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center or hospital medical/surgical unit for intravenous analgesia after orthopedic surgery (e.g., knee arthroplasty) or for acute severe pain when oral administration is not feasible. The clinician orders J0136 (injection, acetaminophen, 10 mg) when the b. Braun intravenous acetaminophen product is used and is not therapeutically equivalent to J0131. The workflow includes physician or advanced practice provider evaluation, informed consent for parenteral analgesic therapy, medication verification by pharmacy, IV catheter placement by nursing, administration and monitoring for hemodynamic stability and sedation, documentation of dose, lot number, and any adverse reaction, and billing of the HCPCS code with appropriate modifiers for site of service, provider status, or extraordinary circumstances. Typical sites of service are hospital inpatient, outpatient hospital infusion center, ambulatory surgery center, or emergency department depending on the clinical scenario.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug discarded/amount wasted | When part of a single-use vial is discarded and only the administered portion is billed (if payer allows reporting of discarded drug units) |