Summary & Overview
HCPCS J1960: Injection, Levorphanol Tartrate, up to 2 mg
HCPCS Level II code J1960 denotes the injection of levorphanol tartrate, up to 2 mg, an opioid analgesic used in clinical settings for moderate to severe pain control. Nationally, accurate coding of parenteral opioid injections supports appropriate clinical documentation, billing integrity, and program oversight for payers and providers. This code is relevant across hospital inpatient and outpatient settings, emergency departments, and clinics where injectable medications are administered.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for J1960, typical sites of service, and which payers commonly process claims for this injectable medication. The publication outlines benchmark considerations, coding and billing nuances that affect claim adjudication, and any notable policy updates or payer-specific guidance when available. Where data elements are absent in the input, the report notes that information is not provided rather than assumed.
This summary equips billing managers, revenue cycle staff, and clinical coders with a focused reference on HCPCS Level II code J1960, enabling clearer communication with payers and consistent documentation for parenteral levorphanol administration.
Billing Code Overview
HCPCS Level II code J1960 represents injection, levorphanol tartrate, up to 2 mg. This code is used to report administration of a parenteral opioid analgesic for pain management.
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Service type: Injectable opioid analgesic administration
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Typical site of service: Hospital inpatient, outpatient clinic, emergency department, or other settings where parenteral medications are administered
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with severe, refractory cancer-related pain presents to an outpatient oncology infusion suite for parenteral opioid administration when oral opioids are ineffective or intolerable. The clinician orders an intravenous or intramuscular injection of levorphanol tartrate for rapid analgesic effect. The typical workflow includes patient assessment (vital signs, pain score, allergies, opioid tolerance), informed consent, medication verification, administration of J1960 (Injection, levorphanol tartrate, up to 2 mg), post-injection monitoring for respiratory depression and sedation, documentation of dose/route/lot number, and discharge instructions. Typical sites of service are hospital outpatient departments, ambulatory infusion centers, urgent care clinics, and skilled nursing facilities. Common clinical indications include severe acute pain, cancer-related pain uncontrolled by oral agents, or situations where gastrointestinal absorption is unreliable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no modifier applies to the service. |
22 | Increased procedural services |