Summary & Overview

HCPCS J1610: Injection, Glucagon Hydrochloride, per 1 mg

HCPCS Level II code J1610 denotes the billed unit for injection of glucagon hydrochloride, measured per 1 mg. Glucagon injections are a critical acute-care medication used to treat severe hypoglycemia and to support certain diagnostic procedures. Nationally, coding and billing for injectable medications like glucagon affect hospital outpatient, emergency, and ambulatory care reimbursement and inventory management.

This publication examines payer coverage and billing benchmarks for Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for glucagon use, payer coverage patterns, common billing modifiers, and typical places of service. The report also highlights benchmarking metrics where available and notes recent policy guidance relevant to HCPCS Level II drug billing.

Intended for revenue cycle managers, clinicians involved in acute-care medication administration, and policy analysts, the piece provides a clear reference for how HCPCS Level II code J1610 is described and applied across care settings. Data not available in the input is identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareJ1610HCPCS Level IIglucagoninjectable medicationhypoglycemia managementdrug billingoutpatient servicesemergency departmentmedication coding

Billing Code Overview

HCPCS Level II code J1610 represents injection, glucagon hydrochloride, per 1 mg. This supply code covers the billed unit for a glucagon hydrochloride injection used to raise blood glucose in patients with severe hypoglycemia or for diagnostic stimulation testing.

Service type: Medication administration (injectable medication)
Typical site of service: Outpatient clinics, emergency departments, urgent care centers, and inpatient hospital settings

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with diabetes mellitus who experiences severe hypoglycemia with altered consciousness or inability to ingest oral glucose, treated in an outpatient clinic, emergency department, or by emergency medical services. The clinician prepares and administers J1610 (glucagon hydrochloride injection) intramuscularly or subcutaneously to rapidly raise blood glucose. The workflow includes verifying the indication (severe hypoglycemia or suspected insulin overdose), confirming allergies and contraindications, drawing the appropriate dose (per mg units billed as J1610), documenting time and route of administration, monitoring blood glucose and vital signs post-administration, and arranging transport to higher level of care if needed. Billing occurs after medication preparation and administration; units billed reflect milligrams of glucagon used. Typical sites of service include ambulance/EMS, emergency department, urgent care, and outpatient clinics with capability for parenteral medication administration.

Coding Specifications

Modifier	Description	When to Use
`23`	Unusual anesthesia	Use if administration occurs with unusual anesthesia circumstances (rare for this drug) when applicable
`25`	Significant, separately identifiable E/M	Use when an evaluation and management service is performed on the same day and is separate from the glucagon administration
`52`	Reduced services	Use when less than the full amount of medication or service is provided and clinically documented
`53`	Discontinued procedure	Use if administration is started but discontinued for clinical reasons
`59`	Distinct procedural service	Use to indicate the glucagon administration is distinct from other procedures on the same day
`62`	Two surgeons	Use when two physicians share surgical responsibility (rarely applicable; included for completeness)
`78`	Unplanned return to OR by same physician	Use if there is an unexpected return to the operating room related to the patient’s condition following administration
`80`	Assistant surgeon	Use when an assistant surgeon participates (rare for this medication)
`91`	Repeat clinical diagnostic laboratory test	Use when repeat measurement (e.g., blood glucose) is performed and billed separately after administration
`JW`	Drug discarded/not administered	Use to denote discarded portion of a single-dose vial not administered when billing for waste is permitted
`JZ`	No drug administered	Use when zero drug was administered (report only where appropriate per payer rules)

Taxonomy Code	Specialty	Notes
207Q00000X	Emergency Medicine	Commonly administers glucagon for prehospital or ED severe hypoglycemia
208D00000X	Family Medicine	Often administers glucagon in clinic or outpatient urgent visits
163W00000X	Paramedic	EMS personnel who commonly administer glucagon in the field
207L00000X	Pediatric Emergency Medicine	Administers glucagon for pediatric severe hypoglycemia
330000000X	Endocrinology	Manages diabetes care; may administer glucagon during acute visits

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E10.649`	Type 1 diabetes mellitus with hypoglycemia without coma	Common indication for glucagon when severe hypoglycemia occurs
`E11.649`	Type 2 diabetes mellitus with hypoglycemia without coma	Indicates hypoglycemia in type 2 diabetes treated with glucagon if severe
`E10.641`	Type 1 diabetes mellitus with hypoglycemic coma	Severe indication where glucagon is used to restore consciousness
`E11.641`	Type 2 diabetes mellitus with hypoglycemic coma	Severe hypoglycemia in type 2 diabetes requiring emergency glucagon
`T38.3X5A`	Adverse effect of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter	Used when hypoglycemia is due to insulin or oral agent overdose and glucagon is administered
`R73.9`	Hyperglycemia, unspecified	Not an indication for glucagon; included only if differential diagnosis considered (note: glucagon raises glucose)
`R55`	Syncope and collapse	May be used when patient presents with loss of consciousness and hypoglycemia is suspected and treated with glucagon

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)	Used when glucagon is administered via subcutaneous or intramuscular injection in clinic or ED
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Data not directly related to glucagon administration but may be performed during visit for behavioral counseling when applicable
`99283`	Emergency department visit, problem-focused	Common E/M level billed for an ED visit where glucagon is given for acute hypoglycemia
`99214`	Office or other outpatient visit, established patient, moderate complexity	May be billed if a clinician performs a significant, separate E/M when glucagon is administered in an outpatient setting
`G0430`	Drug administration, therapeutic, prophylactic, or diagnostic injection (includes infusion), up to 15 minutes	Used by some payers for administration reporting in specific settings (check payer rules)