Summary & Overview
HCPCS J2312: Injection of Naloxone Hydrochloride, 0.01 mg
HCPCS Level II code J2312 denotes an injectable dose of naloxone hydrochloride, 0.01 mg, used to reverse opioid overdose or opioid-induced respiratory depression. This code captures supply of the specific small-dose formulation for parenteral administration and is relevant to acute care settings such as emergency departments, inpatient units, and urgent care centers. Accurate coding of naloxone injections affects clinical documentation, medication inventory tracking, and payer reimbursement for life-saving opioid reversal therapy.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national benchmarks for coding use where available, a concise clinical context for naloxone injection services, and guidance on typical sites of service tied to this HCPCS Level II code. The summary covers common payer considerations and highlights where input data is not available. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J2312 represents an injection of naloxone hydrochloride, not otherwise specified, 0.01 mg. This code describes a parenteral administration of naloxone for reversal of opioid effects.
Service Type: Medication administration (injectable naloxone)
Typical Site of Service: Emergency department, inpatient hospital, urgent care, or other acute care settings where parenteral opioid reversal is provided.
Clinical & Coding Specifications
Clinical Context
A 28-year-old adult presents to an emergency department after a bystander reports suspected opioid overdose with depressed respirations, pinpoint pupils, and reduced responsiveness. Emergency medical services (EMS) arrived, provided airway support, and administered one dose of naloxone intramuscularly. On arrival at the ED, the patient remains obtunded with low respiratory rate; the treating clinician orders an additional naloxone injection using a pre-filled syringe. The medication is billed using J2312 for naloxone hydrochloride per 0.01 mg unit. Typical clinical workflow includes medication verification by nursing, documentation of time and dose administered, monitoring of respiratory status and level of consciousness, and observation for recurrent opioid toxicity or withdrawal. Typical site of service is the emergency department, ambulance/EMS, urgent care, or other acute care settings where injectable naloxone is provided for opioid reversal. Documentation elements include indication (opioid overdose), dose and route, patient response, vital signs before and after administration, and any concurrent life‑support interventions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special circumstances apply to the service. |