Summary & Overview
HCPCS J2210: Methylergonovine Injection, Up to 0.2 mg
HCPCS Level II code J2210 designates an injection of methylergonovine maleate, up to 0.2 mg, commonly administered to induce uterine contraction and manage postpartum bleeding. Nationally, this code is important for billing in obstetric care pathways where rapid pharmacologic control of uterine atony is required. Accurate use affects payment integrity, quality reporting, and inventory tracking for inpatient and outpatient delivery services.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and coding intent, typical sites of service, and the primary considerations that influence billing for injectable uterotonics. The publication outlines standard benchmarks for utilization and payer coverage patterns, highlights relevant policy updates affecting prior authorization and medical necessity determinations, and provides clinical context to help coders and administrators align documentation with billing.
This resource is written for national audiences involved in revenue cycle, maternal health services, and payer contracting. It clarifies what J2210 represents, where it is commonly billed, and what administrative themes—such as documentation requirements and payer variations—most often affect reimbursement and compliance.
Billing Code Overview
HCPCS Level II code J2210 represents an injection of methylergonovine maleate, up to 0.2 mg. This medication is used in obstetric settings to promote uterine contraction and reduce postpartum hemorrhage following delivery.
Service Type: Injection/Medication Administration
Typical Site of Service: Hospital inpatient and outpatient obstetric units, labor and delivery, and other settings where postpartum management occurs
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Clinical & Coding Specifications
Clinical Context
A typical patient is a postpartum adult female who has delivered vaginally or via cesarean section and develops uterine atony with excessive vaginal bleeding within the immediate postpartum period. The patient presents to the delivery suite or operating room with ongoing lochia that is unresponsive to uterotonic agents such as oxytocin and uterine massage. The obstetric team evaluates vital signs, performs a focused exam, obtains intravenous access, and administers uterotonic medications. In this workflow, J2210 (injection, methylergonovine maleate, up to 0.2 mg) is drawn and given intramuscularly or intravenously per facility protocol to promote uterine contraction and reduce hemorrhage. Nursing documents dose, route, time, and response; anesthesia and blood bank are notified if continued hemorrhage requires additional interventions. Typical sites of service include the labor and delivery unit, postpartum recovery area, or operating room for surgical management of hemorrhage.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — neutral | Use when no special modifier applies; most payors prefer standard reporting without additional indicators. |
11 |