Summary & Overview
HCPCS J1938: Injection, Furosemide, 1 mg
HCPCS Level II code J1938 designates injectable furosemide, 1 mg, a commonly used intravenous loop diuretic for acute volume overload and related conditions. Nationally, accurate coding of parenteral diuretics matters for hospital, emergency, and outpatient pharmacy billing because these agents are frequently administered in acute care settings and billed separately from administration services. Proper identification of the drug product supports clinical documentation, inventory management, and payer adjudication.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical role, common sites of service, and the typical payers that reimburse injectable furosemide. The publication provides benchmarking context and policy-relevant considerations such as reimbursement reporting, billing clarity between drug and administration charges, and typical modifiers used in practice. Additionally, the piece summarizes clinical context for when parenteral furosemide is used and highlights where readers can expect variations in coverage and coding practice nationally.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service-line specifics; those items are noted as unavailable where applicable.
Billing Code Overview
HCPCS Level II code J1938 describes an injectable formulation of furosemide, dosed per 1 mg. This code covers the drug product administered by injection and is used to report the medication itself rather than the administration procedure.
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Service type: Medication injection
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Typical site of service: Hospital inpatient, hospital outpatient, emergency department, ambulatory surgical center, or clinic where parenteral medications are administered
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an emergency department, observation unit, or outpatient infusion clinic with acute volume overload from congestive heart failure or significant peripheral/ pulmonary edema requiring rapid diuresis. The clinician orders intravenous furosemide to achieve prompt natriuresis and fluid removal. A registered nurse obtains medication verification, performs baseline vital signs and weight, secures IV access, and administers J1938 (furosemide injection, per mg) at the ordered dose, monitoring urine output, blood pressure, electrolytes, and renal function. Documentation includes indication, dose in milligrams, route (IV or IM), time of administration, patient response, and any adverse events. In inpatient settings this may be part of serial daily dosing; in the ED it may be a single bolus to relieve dyspnea. Typical sites of service are Emergency Department, Hospital Inpatient, Observation Unit, and Outpatient Infusion/Clinic.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered | When part of the vial is wasted and payer requires reporting of discarded medication |
JZ |